Healthcare Provider Details

I. General information

NPI: 1932293933
Provider Name (Legal Business Name): RACHEL HILLIARD FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 VALLEY FORGE ST
COMANCHE TX
76442-1813
US

IV. Provider business mailing address

105 VALLEY FORGE ST
COMANCHE TX
76442-1813
US

V. Phone/Fax

Practice location:
  • Phone: 325-356-7530
  • Fax:
Mailing address:
  • Phone: 325-356-7530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number607582
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: