Basic Information
Provider Information
NPI: 1982652863
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HILL
FirstName: CAROLE
MiddleName: ANN
NamePrefix: MS.
NameSuffix:  
Credential: MS, CRNP
OtherOrganizationName:  
OtherOrganizationType:  
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OtherFirstName:  
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OtherCredential:  
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Mailing Information
Address1: 1808 WOODRAIL DR
Address2:  
City: MILLERSVILLE
State: MD
PostalCode: 211082218
CountryCode: US
TelephoneNumber: 4109870192
FaxNumber:  
Practice Location
Address1: BALTIMORE VA MEDICAL CENTER
Address2: 10 NORTH GREENE STREET
City: BALTIMORE
State: MD
PostalCode: 21201
CountryCode: US
TelephoneNumber: 4106057000
FaxNumber: 4106057873
Other Information
ProviderEnumerationDate: 05/04/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200XR046221MDY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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