Provider Demographics
NPI:1588831564
Name:HILL, BEVERLY LORRAINE (LVN)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:LORRAINE
Last Name:HILL
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11216 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-2353
Mailing Address - Country:US
Mailing Address - Phone:760-486-6389
Mailing Address - Fax:
Practice Address - Street 1:11216 3RD AVE
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-2353
Practice Address - Country:US
Practice Address - Phone:760-486-6389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA206318164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse