Provider Demographics
NPI:1649525189
Name:HILL, ANDREA M (LM)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:M
Last Name:HILL
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1876 TIOVIVO CIR NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-2832
Mailing Address - Country:US
Mailing Address - Phone:505-238-8715
Mailing Address - Fax:
Practice Address - Street 1:123 WELLESLEY DR SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-1443
Practice Address - Country:US
Practice Address - Phone:505-238-8715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-20
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM12098R176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife