Provider Demographics
NPI:1750911525
Name:HILL, REETA FAY (RN)
Entity type:Individual
Prefix:MRS
First Name:REETA
Middle Name:FAY
Last Name:HILL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MULLINS DR STE A1
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355-2868
Mailing Address - Country:US
Mailing Address - Phone:417-660-2005
Mailing Address - Fax:417-666-6185
Practice Address - Street 1:100 MULLINS DR STE A1
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-2868
Practice Address - Country:US
Practice Address - Phone:541-766-0200
Practice Address - Fax:541-766-6618
Is Sole Proprietor?:No
Enumeration Date:2020-01-21
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200642000RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse