Provider Demographics
NPI:1548885866
Name:HILL, SANDRA MARIE (APN)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:MARIE
Last Name:HILL
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 W CHEYENNE AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-8252
Mailing Address - Country:US
Mailing Address - Phone:702-331-1917
Mailing Address - Fax:702-331-5219
Practice Address - Street 1:6330 S JONES BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-3302
Practice Address - Country:US
Practice Address - Phone:702-659-9090
Practice Address - Fax:702-331-5219
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-11
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV828322163WG0000X, 207Q00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty