Provider Demographics
NPI:1801511191
Name:HILL, BREANN (PT, DPT)
Entity type:Individual
Prefix:
First Name:BREANN
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 SILVERADO PINES AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-3575
Mailing Address - Country:US
Mailing Address - Phone:631-902-7309
Mailing Address - Fax:
Practice Address - Street 1:2904 W HORIZON RIDGE PKWY STE 121
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-5016
Practice Address - Country:US
Practice Address - Phone:702-897-7331
Practice Address - Fax:702-897-6801
Is Sole Proprietor?:No
Enumeration Date:2022-10-10
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
NV4997225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist