Provider Demographics
NPI:1508388646
Name:HILL, CALLIE (FNP)
Entity Type:Individual
Prefix:
First Name:CALLIE
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1191 FRANKLIN PKWY
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:GA
Mailing Address - Zip Code:30217-7510
Mailing Address - Country:US
Mailing Address - Phone:706-675-3456
Mailing Address - Fax:706-675-6795
Practice Address - Street 1:1191 FRANKLIN PKWY
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:GA
Practice Address - Zip Code:30217
Practice Address - Country:US
Practice Address - Phone:706-675-3456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-11
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN236319363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily