Basic Information
| Provider Information | |||||||||
| NPI: | 1083788541 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HILL | ||||||||
| FirstName: | BETSY | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | PNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4770 W HERNDON AVE | ||||||||
| Address2: | SUITE 108 | ||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937228401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5592567990 | ||||||||
| FaxNumber: | 5592567991 | ||||||||
| Practice Location | |||||||||
| Address1: | 4770 W HERNDON AVE | ||||||||
| Address2: | SUITE 108 | ||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937228401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5592567990 | ||||||||
| FaxNumber: | 5592567991 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2006 | ||||||||
| LastUpdateDate: | 10/31/2016 | ||||||||
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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 | 363L00000X | NP7101 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LP0200X | NP7101 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics | 163W00000X | RN456885 | CA | N | Nursing Service Providers | Registered Nurse |
No ID Information.