Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 0024173033 | VA |
NPI | 1003289562 |
---|---|
Provider Name | Lisa M Hills I |
First Address | Chesapeake, VA 23321-5526 |
Second Address | Chesapeake, VA 23321-5526 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2015 |
Last Update Date | 05/11/2015 |