Provider Demographics
NPI:1215481858
Name:HILL, AMANDA MARIE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:MARIE
Last Name:HILL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:MARIE
Other - Last Name:ECTOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3510 OLD WASHINGTON RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-3233
Mailing Address - Country:US
Mailing Address - Phone:301-932-5890
Mailing Address - Fax:301-645-6361
Practice Address - Street 1:3510 OLD WASHINGTON RD
Practice Address - Street 2:SUITE 100
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-3233
Practice Address - Country:US
Practice Address - Phone:301-932-5890
Practice Address - Fax:301-645-6361
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR185549363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily