Basic Information
Provider Information
NPI: 1144400375
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HILL
FirstName: ANNE
MiddleName: PHILLIPS
NamePrefix: MS.
NameSuffix:  
Credential: M.F.A., C.A.C.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 AVENUE F NE
Address2:  
City: WINTER HAVEN
State: FL
PostalCode: 338814131
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 5825 US HIGHWAY 27 N
Address2:  
City: SEBRING
State: FL
PostalCode: 338701216
CountryCode: US
TelephoneNumber: 8633855179
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/05/2007
LastUpdateDate: 11/05/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
171M00000X  Y Other Service ProvidersCase Manager/Care Coordinator 

No ID Information.


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