Provider Demographics
NPI:1891914644
Name:HILL, DORIS LYNN (ANPC)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:LYNN
Last Name:HILL
Suffix:
Gender:F
Credentials:ANPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWTHORNE LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-2515
Mailing Address - Country:US
Mailing Address - Phone:704-384-5416
Mailing Address - Fax:
Practice Address - Street 1:130 PLANTATION RIDGE DR STE 100
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-9238
Practice Address - Country:US
Practice Address - Phone:704-316-1635
Practice Address - Fax:704-316-1636
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC005001119363LA2200X
NC124909363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0050-01119OtherMEDICAL BOARD
NC124909OtherRN