Provider Demographics
NPI:1497033641
Name:HILL, DEBBIE (RN,ET)
Entity Type:Individual
Prefix:MISS
First Name:DEBBIE
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:RN,ET
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2461 SANTA MONICA BLVD
Mailing Address - Street 2:#433
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2138
Mailing Address - Country:US
Mailing Address - Phone:323-966-9738
Mailing Address - Fax:
Practice Address - Street 1:2461 SANTA MONICA BLVD
Practice Address - Street 2:#433
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2138
Practice Address - Country:US
Practice Address - Phone:323-966-9738
Practice Address - Fax:323-935-4610
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL313749163WE0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0900XNursing Service ProvidersRegistered NurseEnterostomal Therapy