Provider Demographics
NPI:1497965891
Name:ERNEST-HILL, JEANNELLE A (RN)
Entity Type:Individual
Prefix:MISS
First Name:JEANNELLE
Middle Name:A
Last Name:ERNEST-HILL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-2935
Mailing Address - Country:US
Mailing Address - Phone:914-494-5629
Mailing Address - Fax:
Practice Address - Street 1:300 E PROSPECT AVE
Practice Address - Street 2:STE 2D
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10553-1044
Practice Address - Country:US
Practice Address - Phone:914-494-5629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY678305163W00000X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02825487Medicaid