Basic Information
| Provider Information | |||||||||
| NPI: | 1689112633 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HILL | ||||||||
| FirstName: | PETER | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MSN, AGPC-NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 MARSHLAND RD | ||||||||
| Address2: | SUITE 5 | ||||||||
| City: | HILTON HEAD ISLAND | ||||||||
| State: | SC | ||||||||
| PostalCode: | 299262305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8438426357 | ||||||||
| FaxNumber: | 8438426352 | ||||||||
| Practice Location | |||||||||
| Address1: | 2 MARSHLAND RD | ||||||||
| Address2: | SUITE 5 | ||||||||
| City: | HILTON HEAD ISLAND | ||||||||
| State: | SC | ||||||||
| PostalCode: | 299262305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8438426357 | ||||||||
| FaxNumber: | 8438426352 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2017 | ||||||||
| LastUpdateDate: | 02/09/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP2300X | 20728 | SC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care |
No ID Information.