Provider Demographics
NPI:1063964237
Name:HILL, JONNETTA MARIE (APRN-CNP)
Entity type:Individual
Prefix:MRS
First Name:JONNETTA
Middle Name:MARIE
Last Name:HILL
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 746061
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6061
Mailing Address - Country:US
Mailing Address - Phone:312-733-9730
Mailing Address - Fax:773-866-8014
Practice Address - Street 1:4235 TUSCARAWAS ST W
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-5424
Practice Address - Country:US
Practice Address - Phone:234-203-4232
Practice Address - Fax:330-266-4386
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-03
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.020066363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0200020Medicaid