Provider Demographics
NPI:1639657760
Name:FITZHUGH, HILLARY NICHOLE (CPED)
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:NICHOLE
Last Name:FITZHUGH
Suffix:
Gender:F
Credentials:CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6675 WATERBURY WAY
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-7063
Mailing Address - Country:US
Mailing Address - Phone:912-508-8887
Mailing Address - Fax:
Practice Address - Street 1:2905 VETERANS MEMORIAL HWY STE 2
Practice Address - Street 2:
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-7655
Practice Address - Country:US
Practice Address - Phone:866-712-7837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA224L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist