Provider Demographics
NPI:1730635160
Name:HILL, MARLENE (RN, CPN)
Entity Type:Individual
Prefix:
First Name:MARLENE
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:RN, CPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3013 ELMWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-8774
Mailing Address - Country:US
Mailing Address - Phone:254-383-5243
Mailing Address - Fax:
Practice Address - Street 1:1100 S 33RD ST
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-5238
Practice Address - Country:US
Practice Address - Phone:254-215-7404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX587401163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse