Provider Demographics
NPI:1083493555
Name:HILL, NICOLE (RN 276186)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:RN 276186
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:626 E ELM LN
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85323-4532
Mailing Address - Country:US
Mailing Address - Phone:623-213-4341
Mailing Address - Fax:
Practice Address - Street 1:626 E ELM LN
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-4532
Practice Address - Country:US
Practice Address - Phone:623-213-4341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ276186163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse