Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP07497 | LA |
NPI | 1003249384 |
---|---|
Provider Name | Michelle W. Hilliard |
First Address | Baton Rouge, LA 70814-2576 |
Second Address | Baton Rouge, LA 70806 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2013 |
Last Update Date | 01/08/2018 |