Provider Demographics
NPI:1801099585
Name:HILL, AMANDA ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:ELIZABETH
Last Name:HILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:AMANDA
Other - Middle Name:ELIZABETH
Other - Last Name:OLSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:707 N IOWA ST
Mailing Address - Street 2:
Mailing Address - City:GUNNISON
Mailing Address - State:CO
Mailing Address - Zip Code:81230-2229
Mailing Address - Country:US
Mailing Address - Phone:970-642-8413
Mailing Address - Fax:970-641-9017
Practice Address - Street 1:707 N IOWA ST
Practice Address - Street 2:
Practice Address - City:GUNNISON
Practice Address - State:CO
Practice Address - Zip Code:81230-2229
Practice Address - Country:US
Practice Address - Phone:970-642-8413
Practice Address - Fax:970-641-9017
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT12427208000000X
CO52866208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO50826867Medicaid
CO50826867Medicaid
CO50826867Medicaid