Provider Demographics
NPI:1457626574
Name:HILLSMAN, AMY MARIE (CRNP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:MARIE
Last Name:HILLSMAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 PALMSPRING DR
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-2935
Mailing Address - Country:US
Mailing Address - Phone:301-801-9400
Mailing Address - Fax:
Practice Address - Street 1:6420 ROCKLEDGE DR STE 4100
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-7847
Practice Address - Country:US
Practice Address - Phone:301-571-0019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-22
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR175248363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health