Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 0024170307 | VA |
NPI | 1215286117 |
---|---|
Provider Name | Jean Hill |
First Address | Burke, VA 22015-3729 |
Second Address | Fairfax, VA 22031-4330 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2012 |
Last Update Date | 06/09/2012 |