Provider Demographics
NPI:1265429054
Name:HILE, AMANDA (MS, PA-C)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:HILE
Suffix:
Gender:F
Credentials:MS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8591 HOLLY MEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:PARSONS
Mailing Address - State:WV
Mailing Address - Zip Code:26287-8604
Mailing Address - Country:US
Mailing Address - Phone:304-478-3339
Mailing Address - Fax:304-478-3311
Practice Address - Street 1:3 HEALTH CARE DRIVE
Practice Address - Street 2:
Practice Address - City:PHILIPPI
Practice Address - State:WV
Practice Address - Zip Code:26416
Practice Address - Country:US
Practice Address - Phone:304-457-2800
Practice Address - Fax:304-457-4011
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV20262363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVP00276764OtherRAILROAD MEDICARE
WV1265429054Medicaid
WVQ43351Medicare UPIN
WV1265429054Medicaid