Provider Demographics
NPI:1093849416
Name:HILL, PHYLLIS ANN (ARNP)
Entity type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:ANN
Last Name:HILL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30200 ROAD M.9
Mailing Address - Street 2:
Mailing Address - City:MANCOS
Mailing Address - State:CO
Mailing Address - Zip Code:81328-9239
Mailing Address - Country:US
Mailing Address - Phone:970-903-1208
Mailing Address - Fax:
Practice Address - Street 1:1650 COMMUNITY COLLEGE DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-1144
Practice Address - Country:US
Practice Address - Phone:702-486-7117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK510363LF0000X
CO184068363LF0000X
NVAPRN002034363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily