Provider Demographics
NPI:1447869920
Name:HILL, MACHELE ELIZABETH
Entity type:Individual
Prefix:
First Name:MACHELE
Middle Name:ELIZABETH
Last Name:HILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 AVENUE C BLDG SUITE109
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WV
Mailing Address - Zip Code:25130-1100
Mailing Address - Country:US
Mailing Address - Phone:304-369-6400
Mailing Address - Fax:
Practice Address - Street 1:14657 COAL RIVER RD
Practice Address - Street 2:
Practice Address - City:SETH
Practice Address - State:WV
Practice Address - Zip Code:25181-9082
Practice Address - Country:US
Practice Address - Phone:304-533-7896
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
013537OtherIDK
IDKOtherIDK