Provider Demographics
NPI:1821847989
Name:BLUE HILLS MEDICAL LLC
Entity type:Organization
Organization Name:BLUE HILLS MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP, FNP
Authorized Official - Phone:928-800-1228
Mailing Address - Street 1:8363 E FLORENTINE RD STE B
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-4972
Mailing Address - Country:US
Mailing Address - Phone:928-800-1228
Mailing Address - Fax:928-268-0143
Practice Address - Street 1:8363 E FLORENTINE RD STE B
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-4972
Practice Address - Country:US
Practice Address - Phone:928-800-1228
Practice Address - Fax:928-268-0143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-13
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty