Provider Demographics
NPI:1043768898
Name:HILLS, LORENZO
Entity Type:Individual
Prefix:
First Name:LORENZO
Middle Name:
Last Name:HILLS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3107 BRIAR ROSE CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-0508
Mailing Address - Country:US
Mailing Address - Phone:704-241-9199
Mailing Address - Fax:
Practice Address - Street 1:3107 BRIAR ROSE CT
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-0508
Practice Address - Country:US
Practice Address - Phone:704-241-9199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide