Provider Demographics
NPI:1073835708
Name:HILL, ANA E (RD)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:E
Last Name:HILL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 118008
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29423-8008
Mailing Address - Country:US
Mailing Address - Phone:843-572-7727
Mailing Address - Fax:843-569-5872
Practice Address - Street 1:1516 OLD TROLLEY RD
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-8209
Practice Address - Country:US
Practice Address - Phone:843-820-3410
Practice Address - Fax:843-569-5881
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC107133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDPE077Medicaid
SCDPE078Medicaid
SCDPE079Medicaid
SCDPE076Medicaid
SCDPE075Medicaid
SCDPE083Medicaid
SCDPE080Medicaid
SCDPE085Medicaid
SCQ354127126Medicare PIN
SCDPE079Medicaid
SCDPE083Medicaid
SCQ354126834Medicare UPIN
SCDPE075Medicaid
SCQ354125281Medicare PIN
SCDPE076Medicaid
SCQ354127555Medicare PIN