Provider Demographics
NPI:1962102533
Name:HILL, JESSICA (NP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 445
Mailing Address - Street 2:
Mailing Address - City:WARM SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:31830-0445
Mailing Address - Country:US
Mailing Address - Phone:229-314-7980
Mailing Address - Fax:
Practice Address - Street 1:85 BROAD STREET
Practice Address - Street 2:
Practice Address - City:WARM SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:31830
Practice Address - Country:US
Practice Address - Phone:706-655-3444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-03
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN157812363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN157812OtherAPRN LICENSE