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General NPI Number Information
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NPI Number | 1669667937
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Entity Type | Individual
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Provider Name | PAMELA OWEN HILEY LPN
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Gender | Female
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 10/04/2023
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Provider Practice Location Address
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Address Line | 109 1/2 4TH ST
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City | BEAVER DAM
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State | WI
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Zip | 53916-2051
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Country | US
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Telephone | 920-791-0930
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Fax |
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Provider Business Mailing Address
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Address Line | 109 1/2 4TH ST
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City | BEAVER DAM
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State | WI
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Zip | 53916-2051
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Country | US
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Telephone | 920-791-0930
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Fax |
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 32178-031
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License Number State | WI
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