Provider Demographics
NPI:1700201837
Name:HILL, PAMELA (LPN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:HILL
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 1:3701 CARROLLWOOD PLACE CIR
Mailing Address - Street 2:APT 201
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-3051
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4321 N MACDILL AVE
Practice Address - Street 2:STE 205
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6388
Practice Address - Country:US
Practice Address - Phone:813-961-7440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5190475164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse