Provider Demographics
NPI:1528511532
Name:HILL, ERIN (LAC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 BAYHORSE RD
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:ID
Mailing Address - Zip Code:83313-5076
Mailing Address - Country:US
Mailing Address - Phone:208-309-0484
Mailing Address - Fax:
Practice Address - Street 1:613 N RIVER ST STE B
Practice Address - Street 2:
Practice Address - City:HAILEY
Practice Address - State:ID
Practice Address - Zip Code:83333-8438
Practice Address - Country:US
Practice Address - Phone:208-309-0484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDACU-285171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist