Provider Demographics
NPI:1568629079
Name:HILL, TERESA JEAN
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:JEAN
Last Name:HILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1366 HILL RD
Mailing Address - Street 2:
Mailing Address - City:FORBES
Mailing Address - State:MN
Mailing Address - Zip Code:55738-8302
Mailing Address - Country:US
Mailing Address - Phone:218-427-2285
Mailing Address - Fax:
Practice Address - Street 1:1366 HILL RD
Practice Address - Street 2:
Practice Address - City:FORBES
Practice Address - State:MN
Practice Address - Zip Code:55738-8302
Practice Address - Country:US
Practice Address - Phone:218-427-2285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1047248-1-AFC385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care