Provider Demographics
NPI:1740349117
Name:HILL, SUSAN (MS, RD, CDE)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:MS, RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10101 LINN STATION RD
Mailing Address - Street 2:SUITE 560
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-3848
Mailing Address - Country:US
Mailing Address - Phone:502-412-3253
Mailing Address - Fax:
Practice Address - Street 1:10101 LINN STATION RD
Practice Address - Street 2:SUITE 560
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-3848
Practice Address - Country:US
Practice Address - Phone:502-412-3253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered