Provider Demographics
NPI:1144410481
Name:HILL, DENISE NICOLE (OD)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:NICOLE
Last Name:HILL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 NORTHRIDGE DR STE A
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN
Mailing Address - State:AR
Mailing Address - Zip Code:72956-6983
Mailing Address - Country:US
Mailing Address - Phone:479-262-2080
Mailing Address - Fax:479-262-6940
Practice Address - Street 1:117 NORTHRIDGE DR STE A
Practice Address - Street 2:
Practice Address - City:VAN BUREN
Practice Address - State:AR
Practice Address - Zip Code:72956-6983
Practice Address - Country:US
Practice Address - Phone:479-262-2080
Practice Address - Fax:479-262-6940
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2530152W00000X
AR2597152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR176017722Medicaid
AR176017722Medicaid
AR4T017Medicare PIN