Basic Information
| Provider Information | |||||||||
| NPI: | 1689060824 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HILL | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | O | ||||||||
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| Credential: | WHNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3035 HAMILTON MASON RD | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | HAMILTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450115544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5138944121 | ||||||||
| FaxNumber: | 5138944120 | ||||||||
| Practice Location | |||||||||
| Address1: | 3035 HAMILTON MASON RD | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | HAMILTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450115544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5138944121 | ||||||||
| FaxNumber: | 5138944120 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/14/2015 | ||||||||
| LastUpdateDate: | 01/21/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LW0102X | COA.16622-NP | OH | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health | 363LW0102X | APRN.CNP.16622 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
ID Information
| ID | Type | State | Issuer | Description | 0192835 | 05 | OH | MEDICAID |