Provider Demographics
NPI:1730349952
Name:HILL, MELISSA DE ANN (CST/CFA)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:DE ANN
Last Name:HILL
Suffix:
Gender:F
Credentials:CST/CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:909 9TH AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-3916
Mailing Address - Country:US
Mailing Address - Phone:817-870-5094
Mailing Address - Fax:817-885-7352
Practice Address - Street 1:1319 SUMMIT AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102-4431
Practice Address - Country:US
Practice Address - Phone:817-336-0551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist