Provider Demographics
NPI:1710511712
Name:HILL, SUSAN JANE (RN)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:JANE
Last Name:HILL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:297 GREEN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95066-3004
Mailing Address - Country:US
Mailing Address - Phone:408-786-6298
Mailing Address - Fax:
Practice Address - Street 1:297 GREEN VALLEY RD
Practice Address - Street 2:
Practice Address - City:SCOTTS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95066-3004
Practice Address - Country:US
Practice Address - Phone:408-786-6298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA449930163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health