Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | CNP131102 | ME |
NPI | 1033288378 |
---|---|
Provider Name | Michael S Hiltz |
First Address | Lewiston, ME 04240-3831 |
Second Address | Lewiston, ME 04240-3831 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 14/11/2013 |