Provider Demographics
NPI:1093284762
Name:HILL, ELIZABETH KATHRYN (LMT, CPT, CNA, CET)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:KATHRYN
Last Name:HILL
Suffix:
Gender:F
Credentials:LMT, CPT, CNA, CET
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5143 VANDELIA ST UNIT 204-2
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-8838
Mailing Address - Country:US
Mailing Address - Phone:978-809-0417
Mailing Address - Fax:
Practice Address - Street 1:5143 VANDELIA ST UNIT 204-2
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-8838
Practice Address - Country:US
Practice Address - Phone:978-809-0417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-25
Last Update Date:2018-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR6T6W9Z2246RP1900X
TXNA0060025002376K00000X
TXMT122756225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No376K00000XNursing Service Related ProvidersNurse's Aide