Provider Demographics
NPI:1528949195
Name:HILL, SARA LOUISE
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:LOUISE
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 1:96381 FOXGLOVE WAY
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:OR
Mailing Address - Zip Code:97415-9771
Mailing Address - Country:US
Mailing Address - Phone:530-403-8652
Mailing Address - Fax:
Practice Address - Street 1:96381 FOXGLOVE WAY
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:OR
Practice Address - Zip Code:97415-9771
Practice Address - Country:US
Practice Address - Phone:530-403-8652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORB125074172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver