Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | AP3953 | AZ |
NPI | 1043518707 |
---|---|
Provider Name | Lisette Hill |
First Address | Phoenix, AZ 85037 |
Second Address | Phoenix, AZ 85037-5459 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2011 |
Last Update Date | 29/06/2021 |