Provider Demographics
NPI:1508528324
Name:HILL, SHANNON (FNP-C)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9802 HILL ST
Mailing Address - Street 2:
Mailing Address - City:REESE
Mailing Address - State:MI
Mailing Address - Zip Code:48757-9442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4675 HILL ST STE A
Practice Address - Street 2:
Practice Address - City:CASS CITY
Practice Address - State:MI
Practice Address - Zip Code:48726-1008
Practice Address - Country:US
Practice Address - Phone:989-912-6114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-08
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704326336363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily