Provider Demographics
NPI:1952541534
Name:HILL, EMILY L (PA-C)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:L
Last Name:HILL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:LA
Mailing Address - Zip Code:71373-2837
Mailing Address - Country:US
Mailing Address - Phone:318-336-6500
Mailing Address - Fax:318-336-6676
Practice Address - Street 1:209 FRONT ST
Practice Address - Street 2:
Practice Address - City:VIDALIA
Practice Address - State:LA
Practice Address - Zip Code:71373-2837
Practice Address - Country:US
Practice Address - Phone:318-336-6500
Practice Address - Fax:318-336-6676
Is Sole Proprietor?:No
Enumeration Date:2009-02-23
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPA.200253363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1579556Medicaid
LA57061PB18Medicare PIN