Provider Demographics
NPI:1134538796
Name:HILLHOUSE, CHRISTIE (LPN)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:
Last Name:HILLHOUSE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:CHRISTIE
Other - Middle Name:GAIL
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:1202 S JAMES CAMPBELL BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-5193
Mailing Address - Country:US
Mailing Address - Phone:931-380-0020
Mailing Address - Fax:
Practice Address - Street 1:1202 S JAMES CAMPBELL BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-5193
Practice Address - Country:US
Practice Address - Phone:931-380-0020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-07
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN79185164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse