Provider Demographics
NPI:1912399452
Name:HILL, NATALIE ANN (ANP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:ANN
Last Name:HILL
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1146
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72811-1146
Mailing Address - Country:US
Mailing Address - Phone:479-890-9292
Mailing Address - Fax:479-890-6962
Practice Address - Street 1:5395 W ASH ST STE 2
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72858-9228
Practice Address - Country:US
Practice Address - Phone:479-880-1118
Practice Address - Fax:479-880-1120
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-20
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004294363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARA004294OtherANP LICENSE
ARA004294OtherANP LICENSE