Provider Demographics
NPI:1336340330
Name:HILL, KATHRYN WILLIAMS (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:WILLIAMS
Last Name:HILL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:MOORE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2564
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31203-2565
Mailing Address - Country:US
Mailing Address - Phone:478-746-5644
Mailing Address - Fax:478-745-4849
Practice Address - Street 1:380 HOSPITAL DR
Practice Address - Street 2:SUITE 410
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217
Practice Address - Country:US
Practice Address - Phone:478-746-5644
Practice Address - Fax:478-745-4849
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9246111367500000X
GARN158314367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA886841566BMedicaid
GA886841566CMedicaid
GA886841566KMedicaid
GA580628385OtherTRICARE
GA886841566JMedicaid
GA886841566AMedicaid
GA886841566IMedicaid
GA886841566DMedicaid
GA886841566EMedicaid
GA886841566GMedicaid
GA617633OtherWELLCARE
GA886841566LMedicaid
GA886841566FMedicaid
GA617633OtherWELLCARE
GA886841566IMedicaid