Provider Demographics
NPI:1184634065
Name:HILTABIDEL, ELIZABETH CAROL (MSN, RN, CWOCN)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:CAROL
Last Name:HILTABIDEL
Suffix:
Gender:F
Credentials:MSN, RN, CWOCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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Mailing Address - Street 1:1398 SEQUOIA DRIVE
Mailing Address - Street 2:
Mailing Address - City:LAKE ARROWHEAD
Mailing Address - State:CA
Mailing Address - Zip Code:92352-2908
Mailing Address - Country:US
Mailing Address - Phone:909-558-8718
Mailing Address - Fax:909-558-0201
Practice Address - Street 1:11234 ANDERSON ST
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2804
Practice Address - Country:US
Practice Address - Phone:909-558-7178
Practice Address - Fax:909-558-0201
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA444557163WC2100X, 163WE0900X, 163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WC2100XNursing Service ProvidersRegistered NurseContinence Care
Not Answered163WE0900XNursing Service ProvidersRegistered NurseEnterostomal Therapy
Not Answered163WW0000XNursing Service ProvidersRegistered NurseWound Care