Provider Demographics
NPI:1346822897
Name:HILL, MARLYSHIA MICHELLE (CNA)
Entity Type:Individual
Prefix:
First Name:MARLYSHIA
Middle Name:MICHELLE
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 1:2117 W HASKELL ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74127-5211
Mailing Address - Country:US
Mailing Address - Phone:918-402-1249
Mailing Address - Fax:
Practice Address - Street 1:2117 W HASKELL ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74127-5211
Practice Address - Country:US
Practice Address - Phone:918-402-1249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-24
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No172A00000XOther Service ProvidersDriver