Provider Demographics
NPI:1811563521
Name:HILL, CARL STANLEY (RN)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:STANLEY
Last Name:HILL
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 SUNFLOWER CT
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-0815
Mailing Address - Country:US
Mailing Address - Phone:951-287-4944
Mailing Address - Fax:
Practice Address - Street 1:31 THREE MILE DR STE 102
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-1400
Practice Address - Country:US
Practice Address - Phone:951-287-9444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-RN-LIC-132426163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency