Healthcare Provider Details

I. General information

NPI: 1376105510
Provider Name (Legal Business Name): KARI HILLARD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2019
Last Update Date: 07/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

527 COBB ST
CADILLAC MI
49601-2540
US

IV. Provider business mailing address

527 COBB ST
CADILLAC MI
49601-2540
US

V. Phone/Fax

Practice location:
  • Phone: 231-775-3463
  • Fax:
Mailing address:
  • Phone: 231-775-3463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704285285
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: