Provider Demographics
NPI:1689199861
Name:ST HILAIRE, VICTORIA LILLIOS (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LILLIOS
Last Name:ST HILAIRE
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 BARTLEY AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-2828
Mailing Address - Country:US
Mailing Address - Phone:207-513-9024
Mailing Address - Fax:
Practice Address - Street 1:251 WOODFORD ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-5617
Practice Address - Country:US
Practice Address - Phone:207-732-2828
Practice Address - Fax:207-761-8150
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP171100363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health