Provider Demographics
NPI:1164203196
Name:HILLARD, KATINA (CNP)
Entity Type:Individual
Prefix:
First Name:KATINA
Middle Name:
Last Name:HILLARD
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3503 DEWITT COUNTY CT
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-5574
Mailing Address - Country:US
Mailing Address - Phone:254-350-0641
Mailing Address - Fax:
Practice Address - Street 1:3503 DEWITT COUNTY CT
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-5574
Practice Address - Country:US
Practice Address - Phone:254-350-0641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1128694363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health