MEDICARE: NICOLE HILLIARD CPS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224900000X	Mastectomy Fitter
2	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1326936550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE HILLIARD CPS

Provider Business Mailing Address
First Line	:	6328 BLUE TWILIGHT CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-6446
Country	:	US
Telephone Number	:	470-406-9061
Fax Number	:

Provider Business Practice Location Address
First Line	:	6328 BLUE TWILIGHT CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-6446
Country	:	US
Telephone Number	:	470-406-9061
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2025
Last Update Date	:	06/26/2025

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Directions to “ NICOLE HILLIARD CPS” Practice Location

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