Provider Demographics
NPI:1689006892
Name:HILTNER, KRISTIN NICOLE (PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:NICOLE
Last Name:HILTNER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4773 HIGBEE AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2551
Mailing Address - Country:US
Mailing Address - Phone:330-807-3897
Mailing Address - Fax:
Practice Address - Street 1:4773 HIGBEE AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718
Practice Address - Country:US
Practice Address - Phone:330-492-6500
Practice Address - Fax:330-492-6502
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-30
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.15223-NP363LP0808X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program