Provider Demographics
NPI:1619216645
Name:HILLS, ROSE ANDREA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ROSE
Middle Name:ANDREA
Last Name:HILLS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3657 DOGWOOD FARM RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30034-6403
Mailing Address - Country:US
Mailing Address - Phone:404-310-6760
Mailing Address - Fax:
Practice Address - Street 1:3657 DOGWOOD FARM RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034-6403
Practice Address - Country:US
Practice Address - Phone:404-310-6760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN044423164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse