Provider Demographics
NPI:1275869323
Name:HILL, PATRICIA ANN (CNA)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:HILL
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 VISSER ST
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49456-2063
Mailing Address - Country:US
Mailing Address - Phone:616-607-8527
Mailing Address - Fax:
Practice Address - Street 1:318 VISSER ST
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:MI
Practice Address - Zip Code:49456-2063
Practice Address - Country:US
Practice Address - Phone:616-607-8527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-26
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI230454530299376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI230454530299OtherPROMETRIC