Provider Demographics
NPI:1659061166
Name:HILL, NIA JENAY
Entity Type:Individual
Prefix:
First Name:NIA
Middle Name:JENAY
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 1:3602 DALEFORD AVE NE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44705-4366
Mailing Address - Country:US
Mailing Address - Phone:330-232-6810
Mailing Address - Fax:
Practice Address - Street 1:6679 CARRIAGE LANE AVE NE
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44721-2580
Practice Address - Country:US
Practice Address - Phone:330-208-4720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-09
Last Update Date:2023-08-31
Deactivation Date:2023-05-12
Deactivation Code:
Reactivation Date:2023-08-31
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide