Provider Demographics
NPI:1003289562
Name:HILLS, LISA M I (NP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:HILLS
Suffix:I
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4053 TAYLOR ROAD
Mailing Address - Street 2:SUITE K
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-5526
Mailing Address - Country:US
Mailing Address - Phone:757-483-6401
Mailing Address - Fax:757-686-3025
Practice Address - Street 1:4350 TAYLOR ROAD
Practice Address - Street 2:SUITE K
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-5526
Practice Address - Country:US
Practice Address - Phone:757-483-6401
Practice Address - Fax:757-686-3025
Is Sole Proprietor?:No
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024173033363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner