Provider Demographics
NPI:1114055985
Name:HILL, MARY HARBERT (FNP-C)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:HARBERT
Last Name:HILL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 RUSTIC CT
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-2725
Mailing Address - Country:US
Mailing Address - Phone:970-226-3584
Mailing Address - Fax:
Practice Address - Street 1:HARTSHORN HEALTH SERVICE
Practice Address - Street 2:COLORADO STATE UNIVERSITY
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80523-8031
Practice Address - Country:US
Practice Address - Phone:970-491-7121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO59619363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily