Provider Demographics
NPI:1174190516
Name:HILSON, JASMINE BIANCA-SYMONE (PA)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:BIANCA-SYMONE
Last Name:HILSON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1751 VETERANS DR STE 300
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-4930
Mailing Address - Country:US
Mailing Address - Phone:256-718-3200
Mailing Address - Fax:
Practice Address - Street 1:1751 VETERANS DR STE 300
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-4930
Practice Address - Country:US
Practice Address - Phone:256-718-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-04
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1805363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical