Provider Demographics
NPI:1851400980
Name:HILT, JANE PRUETT (PT)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:PRUETT
Last Name:HILT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 DEFENSE HWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-2926
Mailing Address - Country:US
Mailing Address - Phone:410-721-9000
Mailing Address - Fax:410-721-8185
Practice Address - Street 1:2200 DEFENSE HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-2926
Practice Address - Country:US
Practice Address - Phone:410-721-9000
Practice Address - Fax:410-721-8185
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14519225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR926-0001OtherCAREFIRST BC/BS FEP
MD529947OtherAETNA HMO
MD5387476OtherAETNA PPO
MD214517OtherMDIPA/OC/MAMSI/APPO
MD544075-01OtherCAREFIRST BLUE CROSS/BLUE
MDKY69CROtherCAREFIRST BC/BS NATL'L
MD214517OtherMDIPA/OC/MAMSI/APPO