Provider Demographics
NPI:1235437187
Name:HILL, KIMBERLY KATHLEEN (MSPO, LCPO)
Entity Type:Individual
Prefix:MISS
First Name:KIMBERLY
Middle Name:KATHLEEN
Last Name:HILL
Suffix:
Gender:F
Credentials:MSPO, LCPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:598 SWEETFERN LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30518-7613
Mailing Address - Country:US
Mailing Address - Phone:678-234-1298
Mailing Address - Fax:
Practice Address - Street 1:598 SWEETFERN LN
Practice Address - Street 2:
Practice Address - City:SUGAR HILL
Practice Address - State:GA
Practice Address - Zip Code:30518-7613
Practice Address - Country:US
Practice Address - Phone:678-234-1298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA100222Z00000X, 224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist