Provider Demographics
NPI:1790135341
Name:HILL, BRENZELLA
Entity Type:Individual
Prefix:MS
First Name:BRENZELLA
Middle Name:
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 1:217 E STONE AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609-5660
Mailing Address - Country:US
Mailing Address - Phone:864-363-0322
Mailing Address - Fax:
Practice Address - Street 1:217 E STONE AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609-5660
Practice Address - Country:US
Practice Address - Phone:864-363-0322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-14
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Yes253Z00000XAgenciesIn Home Supportive Care