Provider Demographics
NPI:1205093713
Name:HILL, MURREN S (PSYD)
Entity type:Individual
Prefix:DR
First Name:MURREN
Middle Name:S
Last Name:HILL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4231 MAGNOLIA RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-6951
Mailing Address - Country:US
Mailing Address - Phone:904-226-7259
Mailing Address - Fax:
Practice Address - Street 1:414 OLD HARD RD
Practice Address - Street 2:SUITE 108
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-3406
Practice Address - Country:US
Practice Address - Phone:904-226-7259
Practice Address - Fax:904-900-5529
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7718103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000133700Medicaid
FLAL7742Medicare PIN