Provider Demographics
NPI:1790453249
Name:HILL, MARIMICHAEL ASHTON (FNP-C)
Entity Type:Individual
Prefix:
First Name:MARIMICHAEL
Middle Name:ASHTON
Last Name:HILL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:874 BARNES CROSSING RD
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-0909
Mailing Address - Country:US
Mailing Address - Phone:662-841-0002
Mailing Address - Fax:662-510-0216
Practice Address - Street 1:874 BARNES CROSSING RD
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-0909
Practice Address - Country:US
Practice Address - Phone:662-841-0002
Practice Address - Fax:662-510-0216
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-31
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS904846363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily