Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | RN251757 | GA |
NPI | 1003426537 |
---|---|
Provider Name | Hilarie Hincy Rankin |
First Address | Rome, GA 30165-1369 |
Second Address | Rome, GA 30165-1416 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2020 |
Last Update Date | 16/09/2020 |