Provider Demographics
NPI:1124878178
Name:HILL, WANDA M
Entity type:Individual
Prefix:
First Name:WANDA
Middle Name:M
Last Name:HILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14724 WESTROPP AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44110-1837
Mailing Address - Country:US
Mailing Address - Phone:216-402-3525
Mailing Address - Fax:
Practice Address - Street 1:14724 WESTROPP AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44110-1837
Practice Address - Country:US
Practice Address - Phone:216-402-3525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant