Provider Demographics
NPI:1174296818
Name:HILLARD, QUINTRELL
Entity Type:Individual
Prefix:MS
First Name:QUINTRELL
Middle Name:
Last Name:HILLARD
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:QUINTRELL
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8141 SHELDON RD APT 100
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-1279
Mailing Address - Country:US
Mailing Address - Phone:817-907-9217
Mailing Address - Fax:
Practice Address - Street 1:8141 SHELDON RD APT 100
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-1279
Practice Address - Country:US
Practice Address - Phone:817-907-9217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)