Provider Demographics
NPI:1457908956
Name:HILL, MARNETTE ELAINE (NEMT)
Entity Type:Individual
Prefix:
First Name:MARNETTE
Middle Name:ELAINE
Last Name:HILL
Suffix:
Gender:F
Credentials:NEMT
Other - Prefix:
Other - First Name:MARNETTE
Other - Middle Name:ELAINE
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NEMT
Mailing Address - Street 1:8561 MILSAP CT
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-1269
Mailing Address - Country:US
Mailing Address - Phone:916-821-8964
Mailing Address - Fax:
Practice Address - Street 1:8561 MILSAP CT
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-1269
Practice Address - Country:US
Practice Address - Phone:916-821-8964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC6635463343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)