Provider Demographics
NPI:1659600914
Name:HILL, ANDREA C
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:C
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:P.O. BOX 886
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:WY
Mailing Address - Zip Code:83110
Mailing Address - Country:US
Mailing Address - Phone:307-654-1913
Mailing Address - Fax:
Practice Address - Street 1:80 WESTERN DRIVE
Practice Address - Street 2:
Practice Address - City:SMOOT
Practice Address - State:WY
Practice Address - Zip Code:83126
Practice Address - Country:US
Practice Address - Phone:307-654-1913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator