Provider Demographics
NPI:1609371574
Name:HILL, ELISE ELEANOR
Entity Type:Individual
Prefix:
First Name:ELISE
Middle Name:ELEANOR
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 1:312 COURT AVE APT 205
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-2453
Mailing Address - Country:US
Mailing Address - Phone:515-401-2537
Mailing Address - Fax:
Practice Address - Street 1:312 COURT AVE APT 205
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-2453
Practice Address - Country:US
Practice Address - Phone:515-401-2537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-24
Last Update Date:2018-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program