Provider Demographics
NPI:1235646688
Name:HILL, CHELSEA (FNP-C)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
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 1:111 MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:MS
Mailing Address - Zip Code:39652-2825
Mailing Address - Country:US
Mailing Address - Phone:601-783-2374
Mailing Address - Fax:601-783-5126
Practice Address - Street 1:3000 PLAZA DR STE C
Practice Address - Street 2:
Practice Address - City:TYLERTOWN
Practice Address - State:MS
Practice Address - Zip Code:39667-9227
Practice Address - Country:US
Practice Address - Phone:601-803-5676
Practice Address - Fax:601-803-5677
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-08
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS893734363LF0000X
MS902461363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily