Provider Demographics
NPI:1952536831
Name:HILL, SUSAN POWELL (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:POWELL
Last Name:HILL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:BARID
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:379 VICK CIR
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-3294
Mailing Address - Country:US
Mailing Address - Phone:205-655-0200
Mailing Address - Fax:
Practice Address - Street 1:379 VICK CIR
Practice Address - Street 2:
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35173-3294
Practice Address - Country:US
Practice Address - Phone:205-655-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-21
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-068161363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALP09248Medicare UPIN