Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 553 | NC |
NPI | 1013005073 |
---|---|
Provider Name | Pamela L Hill |
First Address | Swansboro, NC 28584-9654 |
Second Address | New Bern, NC 28560-4629 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
42384 | BLUE CROSS BLUE SHIELD (01) | NC |
7342384 | (05) | NC |