Basic Information
| Provider Information | |||||||||
| NPI: | 1295079556 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HILL | ||||||||
| FirstName: | DARRELL | ||||||||
| MiddleName: | RAY | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1109 N GLENN ENGLISH ST | ||||||||
| Address2: | |||||||||
| City: | CORDELL | ||||||||
| State: | OK | ||||||||
| PostalCode: | 736322007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5808322222 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1220 N GLENN ENGLISH ST | ||||||||
| Address2: | |||||||||
| City: | CORDELL | ||||||||
| State: | OK | ||||||||
| PostalCode: | 736322010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5808323339 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/26/2012 | ||||||||
| LastUpdateDate: | 02/17/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | R0057113 | OK | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.