Provider Demographics
NPI:1417994427
Name:HILLIARD, LISA K (PA-C)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:K
Last Name:HILLIARD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:KAY
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 LOTHROP STREET
Mailing Address - Street 2:FORBES TOWER, SUITE 9055
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2536
Mailing Address - Country:US
Mailing Address - Phone:412-647-3087
Mailing Address - Fax:
Practice Address - Street 1:1500 FIFTH AVENUE
Practice Address - Street 2:ERMI QUANTUM ONE
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15132
Practice Address - Country:US
Practice Address - Phone:412-664-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA000961L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS63237Medicare UPIN
PA026471Medicare ID - Type Unspecified