Provider Demographics
NPI:1053702761
Name:HILL, KATHLEEN ELLEN (CNM)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:ELLEN
Last Name:HILL
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:MRS
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNM
Mailing Address - Street 1:PO BOX 5208
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39302-5208
Mailing Address - Country:US
Mailing Address - Phone:601-486-4210
Mailing Address - Fax:601-486-4219
Practice Address - Street 1:905C S FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-6113
Practice Address - Country:US
Practice Address - Phone:601-486-4210
Practice Address - Fax:601-486-4219
Is Sole Proprietor?:No
Enumeration Date:2015-02-17
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife