Provider Demographics
NPI:1932442241
Name:HILL, TIFFANY MARIE
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:MARIE
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 1:1551 PROSPECT RD
Mailing Address - Street 2:
Mailing Address - City:ARAGON
Mailing Address - State:GA
Mailing Address - Zip Code:30104-2443
Mailing Address - Country:US
Mailing Address - Phone:678-883-4866
Mailing Address - Fax:
Practice Address - Street 1:1551 PROSPECT RD
Practice Address - Street 2:
Practice Address - City:ARAGON
Practice Address - State:GA
Practice Address - Zip Code:30104-2443
Practice Address - Country:US
Practice Address - Phone:678-883-4866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-04
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X, 372600000X
GACN0028885831376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No253Z00000XAgenciesIn Home Supportive Care
No372600000XNursing Service Related ProvidersAdult Companion