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General NPI Number Information
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NPI Number | 1962989921
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Entity Type | Individual
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Provider Name | ERIC HILT
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Gender | Male
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Dates
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Enumeration Date | 07/23/2018
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Last Update Date | 07/23/2018
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Provider Practice Location Address
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Address Line | 376 E APPLE AVE
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City | MUSKEGON
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State | MI
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Zip | 49442-3466
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Country | US
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Telephone | 231-724-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 555 LAKE FOREST LN APT 9
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City | NORTON SHORES
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State | MI
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Zip | 49441-6506
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Country | US
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Telephone | 231-215-4185
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 4704328966
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License Number State | MI
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