Provider Demographics
NPI:1720444615
Name:HILL, JACQUI LYNN (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:JACQUI
Middle Name:LYNN
Last Name:HILL
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 UNDERCLIFF TERRACE
Mailing Address - Street 2:INAS ALATTAR- PEDIATRICS
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740
Mailing Address - Country:US
Mailing Address - Phone:304-487-0415
Mailing Address - Fax:
Practice Address - Street 1:143 UNDERCLIFF TER
Practice Address - Street 2:INAS ALATTAR - PEDIATRICS
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-2175
Practice Address - Country:US
Practice Address - Phone:304-487-0415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-07
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV60105363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner