Provider Demographics
NPI:1538585385
Name:HILL, BONNIE (APRN)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 PROFESSIONAL PARK DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LOUISA
Mailing Address - State:KY
Mailing Address - Zip Code:41230-9644
Mailing Address - Country:US
Mailing Address - Phone:606-638-4656
Mailing Address - Fax:606-638-4658
Practice Address - Street 1:32 PROFESSIONAL PARK DR
Practice Address - Street 2:SUITE 102
Practice Address - City:LOUISA
Practice Address - State:KY
Practice Address - Zip Code:41230-9644
Practice Address - Country:US
Practice Address - Phone:606-638-4656
Practice Address - Fax:606-638-4658
Is Sole Proprietor?:No
Enumeration Date:2014-03-17
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3008563363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily