Provider Demographics
NPI:1164276234
Name:HILLMAN, ROSANNA (LPN)
Entity Type:Individual
Prefix:
First Name:ROSANNA
Middle Name:
Last Name:HILLMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3989 FORK MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:VA
Mailing Address - Zip Code:24151-3641
Mailing Address - Country:US
Mailing Address - Phone:540-520-4284
Mailing Address - Fax:
Practice Address - Street 1:3989 FORK MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:VA
Practice Address - Zip Code:24151-3641
Practice Address - Country:US
Practice Address - Phone:540-520-4284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002084238164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty