Provider Demographics
NPI:1497048862
Name:HILL, TAMMY JOE (NP)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:JOE
Last Name:HILL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-5756
Mailing Address - Country:US
Mailing Address - Phone:989-894-4015
Mailing Address - Fax:989-895-2083
Practice Address - Street 1:1200 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-5756
Practice Address - Country:US
Practice Address - Phone:989-895-4015
Practice Address - Fax:989-895-2083
Is Sole Proprietor?:No
Enumeration Date:2011-05-18
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704210801363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care