Provider Demographics
NPI:1184864506
Name:HILLS, LORA (FNP)
Entity Type:Individual
Prefix:
First Name:LORA
Middle Name:
Last Name:HILLS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4046
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65808-4046
Mailing Address - Country:US
Mailing Address - Phone:417-886-2219
Mailing Address - Fax:417-886-2293
Practice Address - Street 1:3315 S. CAMPBELL
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-4914
Practice Address - Country:US
Practice Address - Phone:417-886-2219
Practice Address - Fax:417-886-2293
Is Sole Proprietor?:No
Enumeration Date:2009-02-25
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO092156363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily