Provider Demographics
NPI:1427602705
Name:HILLIARD, LAURA (PA-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:HILLIARD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 HOT AND COLD LN
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:MA
Mailing Address - Zip Code:02726-2425
Mailing Address - Country:US
Mailing Address - Phone:508-558-6419
Mailing Address - Fax:
Practice Address - Street 1:1539 ATWOOD AVE STE 301
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-3262
Practice Address - Country:US
Practice Address - Phone:401-490-4515
Practice Address - Fax:401-490-4516
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant