Provider Demographics
NPI:1679295182
Name:HILL, SAMUEL LINDSEY JR (NP)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:LINDSEY
Last Name:HILL
Suffix:JR
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 SUNDANCE DR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-3177
Mailing Address - Country:US
Mailing Address - Phone:601-433-1618
Mailing Address - Fax:
Practice Address - Street 1:1709 61ST AVE
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-3044
Practice Address - Country:US
Practice Address - Phone:970-330-0333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-13
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS905525363L00000X
COC-APN.0102503-C-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner