Provider Demographics
NPI:1245374008
Name:HILL, MELISSA EVA (PA)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:EVA
Last Name:HILL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 I ST
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95901-5626
Mailing Address - Country:US
Mailing Address - Phone:530-743-5125
Mailing Address - Fax:530-743-4528
Practice Address - Street 1:401 I ST
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:CA
Practice Address - Zip Code:95901-5626
Practice Address - Country:US
Practice Address - Phone:530-743-5125
Practice Address - Fax:530-743-4528
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA12652363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MR0550586OtherDEA NUMBER
R40758Medicare UPIN
CAWPA12652AMedicare ID - Type Unspecified