Pamela Ann Hills, TEACHING

Individual provider Active NPI Contractor · Nichols, SC

NPI 1972904472 · NPPES record last updated Sep 16, 2014

Key facts

NPI
1972904472
Entity type
Individual (NPI type 1)
Primary specialty
Contractor 171W00000X
License
C122009000619 (CT)
Practice address
403 South Nichols Street
Nichols, SC 29581-0232
Phone
(860) 818-2595
NPI assigned
Sep 16, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
C122009000619CTMDContractor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X C122009000619 CT Yes

Addresses

Primary practice location

403 South Nichols Street
Nichols, SC 29581-0232

Mailing address

PO Box 232
403 South Nichols Street
Nichols, SC 29581-0232
Phone (860) 818-2595

Other identifiers

IdentifierTypeStateIssuer
C122009000691OtherCTCONNECTICUT STATE DEPARTMENT OF EDUCATION

Other providers in Nichols, SC

All providers in Nichols, SC · Contractor in South Carolina

Sources for this page

Verify at the official NPI Registry.