Provider Demographics
NPI:1700421211
Name:HILL, MELISSA ANN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ANN
Last Name:HILL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:901 EAGLE RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-9121
Mailing Address - Country:US
Mailing Address - Phone:651-486-8371
Mailing Address - Fax:
Practice Address - Street 1:212 W LAKE ST
Practice Address - Street 2:
Practice Address - City:WACONIA
Practice Address - State:MN
Practice Address - Zip Code:55387-1014
Practice Address - Country:US
Practice Address - Phone:651-603-4565
Practice Address - Fax:833-630-0621
Is Sole Proprietor?:No
Enumeration Date:2019-11-08
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2016027219363LF0000X
MN5198363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily