Provider Demographics
NPI:1528721537
Name:HILL, KELLY (NP, WHNP-BC)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:NP, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-2948
Mailing Address - Country:US
Mailing Address - Phone:781-492-2553
Mailing Address - Fax:
Practice Address - Street 1:301 SETON PKWY STE 407
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-8003
Practice Address - Country:US
Practice Address - Phone:832-454-3636
Practice Address - Fax:512-380-0632
Is Sole Proprietor?:No
Enumeration Date:2021-10-17
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1042415163W00000X, 363LW0102X
MARN2347382163W00000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse