Provider Demographics
NPI:1295079556
Name:HILL, DARRELL RAY (CNP)
Entity type:Individual
Prefix:MR
First Name:DARRELL
Middle Name:RAY
Last Name:HILL
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1109 N GLENN ENGLISH ST
Mailing Address - Street 2:
Mailing Address - City:CORDELL
Mailing Address - State:OK
Mailing Address - Zip Code:73632-2007
Mailing Address - Country:US
Mailing Address - Phone:580-832-2222
Mailing Address - Fax:
Practice Address - Street 1:1220 N GLENN ENGLISH ST
Practice Address - Street 2:
Practice Address - City:CORDELL
Practice Address - State:OK
Practice Address - Zip Code:73632-2010
Practice Address - Country:US
Practice Address - Phone:580-832-3339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-26
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0057113363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner