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General NPI Number Information
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NPI Number | 1376783993
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Entity Type | Individual
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Provider Name | NINA DANTZLER LILLARD PMHCNS-BC
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Gender | Female
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Dates
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Enumeration Date | 02/22/2009
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Last Update Date | 06/24/2010
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Provider Practice Location Address
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Address Line | 858 2ND ST NE
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City | HICKORY
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State | NC
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Zip | 28601-3877
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Country | US
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Telephone | 828-327-6633
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Fax | 828-327-3385
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Provider Business Mailing Address
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Address Line | 858 2ND ST NE
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City | HICKORY
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State | NC
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Zip | 28601-3877
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Country | US
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Telephone | 828-327-6633
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Fax | 828-327-3385
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 99155
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License Number State | NC
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