Provider Demographics
NPI:1760854491
Name:HILT, TINA LYN (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:LYN
Last Name:HILT
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2045 WESTGATE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-7480
Mailing Address - Country:US
Mailing Address - Phone:610-954-5433
Mailing Address - Fax:
Practice Address - Street 1:2045 WESTGATE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7480
Practice Address - Country:US
Practice Address - Phone:610-954-5433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN564322163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology