Basic Information
| Provider Information | |||||||||
| NPI: | 1891914644 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HILL | ||||||||
| FirstName: | DORIS | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | ANPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 HAWTHORNE LN | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282042515 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043845416 | ||||||||
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| Practice Location | |||||||||
| Address1: | 130 PLANTATION RIDGE DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | MOORESVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 281179238 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043161635 | ||||||||
| FaxNumber: | 7043161636 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2007 | ||||||||
| LastUpdateDate: | 02/02/2018 | ||||||||
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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 | 363LA2200X | 005001119 | NC | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363L00000X | 124909 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 0050-01119 | 01 | NC | MEDICAL BOARD | OTHER | 124909 | 01 | NC | RN | OTHER |