Provider Demographics
NPI:1477449700
Name:CHISHOLM, PIL N I (LMBT)
Entity type:Individual
Prefix:MRS
First Name:PIL
Middle Name:N
Last Name:CHISHOLM
Suffix:I
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1127 HARDWICK DR
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-9967
Mailing Address - Country:US
Mailing Address - Phone:615-927-5157
Mailing Address - Fax:
Practice Address - Street 1:1127 HARDWICK DR
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-9967
Practice Address - Country:US
Practice Address - Phone:615-927-5157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16403225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist