Provider Demographics
NPI:1396098992
Name:HILL, SARA NICOLE
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:NICOLE
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 1:3804 HIGHWAY 13 S
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:TN
Mailing Address - Zip Code:37096-4037
Mailing Address - Country:US
Mailing Address - Phone:931-209-4527
Mailing Address - Fax:
Practice Address - Street 1:700 HIGHWAY 100
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:TN
Practice Address - Zip Code:37033-1108
Practice Address - Country:US
Practice Address - Phone:931-729-3573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator