Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | RN030259 | AZ |
NPI | 1003983560 |
---|---|
Provider Name | Judy May Hileman |
First Address | Tucson, AZ 85730-1254 |
Second Address | Tucson, AZ 85730-1254 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P36125 | (02) | AZ |