Basic Information
| Provider Information | |||||||||
| NPI: | 1073835708 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HILL | ||||||||
| FirstName: | ANA | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | RD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 118008 | ||||||||
| Address2: | |||||||||
| City: | CHARLESTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294238008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8435727727 | ||||||||
| FaxNumber: | 8435695872 | ||||||||
| Practice Location | |||||||||
| Address1: | 1516 OLD TROLLEY RD | ||||||||
| Address2: | |||||||||
| City: | SUMMERVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294858209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8438203410 | ||||||||
| FaxNumber: | 8435695881 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2010 | ||||||||
| LastUpdateDate: | 07/07/2011 | ||||||||
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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 | 133V00000X | 107 | SC | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
ID Information
| ID | Type | State | Issuer | Description | DPE077 | 05 | SC | MEDICAID | DPE078 | 05 | SC | MEDICAID | DPE079 | 05 | SC | MEDICAID | DPE076 | 05 | SC | MEDICAID | DPE075 | 05 | SC | MEDICAID | DPE083 | 05 | SC | MEDICAID | DPE080 | 05 | SC | MEDICAID | DPE085 | 05 | SC | MEDICAID |