Provider Demographics
NPI:1578284774
Name:LUCAS HILL, NIKKIA (RRT)
Entity Type:Individual
Prefix:MISS
First Name:NIKKIA
Middle Name:
Last Name:LUCAS HILL
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 KINGSTON TRL
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-3257
Mailing Address - Country:US
Mailing Address - Phone:678-697-2890
Mailing Address - Fax:
Practice Address - Street 1:344 CHATEAUGUAY DR
Practice Address - Street 2:
Practice Address - City:ELLENWOOD
Practice Address - State:GA
Practice Address - Zip Code:30294-2957
Practice Address - Country:US
Practice Address - Phone:678-697-2890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5542227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAUNKNOWNOtherUNKNOWN