Basic Information
| Provider Information | |||||||||
| NPI: | 1982712600 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HILL | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 206 PARK PLACE BLVD | ||||||||
| Address2: | |||||||||
| City: | KISSIMMEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347412344 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078460023 | ||||||||
| FaxNumber: | 4074831064 | ||||||||
| Practice Location | |||||||||
| Address1: | 206 PARK PLACE BLVD | ||||||||
| Address2: | |||||||||
| City: | KISSIMMEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347412344 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078460023 | ||||||||
| FaxNumber: | 4074831064 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2006 | ||||||||
| LastUpdateDate: | 10/11/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | ARNP 1791602 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
ID Information
| ID | Type | State | Issuer | Description | 041-219152 | 01 | IL | REGISTERED PROF NURSE | OTHER | 9-14-04 TO 9-13-09 | 01 | ANCC | OTHER | F11010077 | 01 | AANP | OTHER |