Provider Demographics
NPI:1790540367
Name:HILL, MISTY
Entity Type:Individual
Prefix:
First Name:MISTY
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 1:1830 SHOSHONI DR
Mailing Address - Street 2:
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-9152
Mailing Address - Country:US
Mailing Address - Phone:740-601-8789
Mailing Address - Fax:
Practice Address - Street 1:1830 SHOSHONI DR
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-9152
Practice Address - Country:US
Practice Address - Phone:740-601-8789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No171400000XOther Service ProvidersHealth & Wellness Coach
No172A00000XOther Service ProvidersDriver