Provider Demographics
NPI:1639696792
Name:LIDDICK, HILLARY E (APRN)
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:E
Last Name:LIDDICK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:HILLARY
Other - Middle Name:
Other - Last Name:PAWULAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:111 SARANAC ST STE 164
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561-4088
Mailing Address - Country:US
Mailing Address - Phone:603-601-4101
Mailing Address - Fax:
Practice Address - Street 1:111 SARANAC ST STE 164
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:NH
Practice Address - Zip Code:03561-4088
Practice Address - Country:US
Practice Address - Phone:603-601-4101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-29
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT1010132681363LP0808X
NH092840-23363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health