Provider Demographics
NPI:1235792144
Name:HILL, CHANTEA SHAREE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CHANTEA
Middle Name:SHAREE
Last Name:HILL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 E CENTRAL TEXAS EXPY STE D
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-1900
Mailing Address - Country:US
Mailing Address - Phone:808-561-0444
Mailing Address - Fax:
Practice Address - Street 1:451 E CENTRAL TEXAS EXPY STE D
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-1900
Practice Address - Country:US
Practice Address - Phone:808-561-0444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-16
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141292363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care