Provider Demographics
NPI:1598232712
Name:RICHARDSON HILL, NICOLE YVONNE (CNA)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:YVONNE
Last Name:RICHARDSON HILL
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 CANEY OAKS DRIVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-9080
Mailing Address - Country:US
Mailing Address - Phone:904-532-8059
Mailing Address - Fax:866-307-8444
Practice Address - Street 1:2333 CANEY OAKS DRIVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218
Practice Address - Country:US
Practice Address - Phone:904-532-8059
Practice Address - Fax:866-307-8444
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-25
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL820671439Medicaid