Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | SP013447 | PA |
NPI | 1003232430 |
---|---|
Provider Name | Janice B. Hilley |
First Address | Laurel, DE 19956-3960 |
Second Address | Seaford, DE 19973-3600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2014 |
Last Update Date | 15/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003232430 | (05) | PA |