Individual
MR. JERRY RUSSELL HILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
205 OSCEOLA ST, LAURIUM, MI 49913-2134
(906) 337-6500
(906) 523-6129
Mailing address
24559 S KLINGVILLE RD, CHASSELL, MI 49916-9265
(906) 523-6129
(906) 523-6129
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704093472
MI
367500000X
Certified Registered Nurse Anesthetist
RNA203021
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704093472
MICHIGAN LICENSE
MI
01
—
RN76197
RN LICENSE
ME
01
—
RNA203021
CRNA LICENSE
ME
Enumeration date
08/10/2005
Last updated
06/03/2020
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