Provider Demographics
NPI:1922018068
Name:HILL, MICHELLE LEILANI (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:LEILANI
Last Name:HILL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 N KALAHEO AVE STE C315
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-1883
Mailing Address - Country:US
Mailing Address - Phone:808-254-5577
Mailing Address - Fax:
Practice Address - Street 1:970 N KALAHEO AVE STE C315
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-1883
Practice Address - Country:US
Practice Address - Phone:808-254-5577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-30277111N00000X
HIDC-1084111N00000X
HIACU-831171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIV10139Medicare UPIN
HI102395Medicare PIN