Provider Demographics
NPI:1013024033
Name:HILL, PATRICK D (FNP)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:D
Last Name:HILL
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 714
Mailing Address - Street 2:
Mailing Address - City:MADILL
Mailing Address - State:OK
Mailing Address - Zip Code:73446-0714
Mailing Address - Country:US
Mailing Address - Phone:580-263-0091
Mailing Address - Fax:
Practice Address - Street 1:4215 JOE RAMSEY BLVD E
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-7852
Practice Address - Country:US
Practice Address - Phone:580-263-0091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2014-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX652896363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX199545803Medicaid
TX8N9894OtherBLUECROSS BLUE SHIELD
TXP00814345OtherRAILROAD
TX8Y1145OtherBLUE CROSS BLUE SHIELD
TX8L23006Medicare PIN
TX8Y1145OtherBLUE CROSS BLUE SHIELD
TX8N9894OtherBLUECROSS BLUE SHIELD
TX199545803Medicaid
TXP00304663Medicare PIN
Q65397Medicare UPIN