Provider Demographics
NPI:1861004046
Name:HILYARD, JOHN CANNON (PHARM D)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CANNON
Last Name:HILYARD
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 NAVAJO DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-5517
Mailing Address - Country:US
Mailing Address - Phone:702-466-6408
Mailing Address - Fax:
Practice Address - Street 1:1017 NEVADA WAY
Practice Address - Street 2:
Practice Address - City:BOULDER CITY
Practice Address - State:NV
Practice Address - Zip Code:89005-1801
Practice Address - Country:US
Practice Address - Phone:702-293-6705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-19
Last Update Date:2021-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV20595183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist