Provider Demographics
NPI:1336812395
Name:HILLMAN, MICHELLE E
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:E
Last Name:HILLMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 LOOKOUT DR
Mailing Address - Street 2:
Mailing Address - City:EUFAULA
Mailing Address - State:AL
Mailing Address - Zip Code:36027-4845
Mailing Address - Country:US
Mailing Address - Phone:334-355-0466
Mailing Address - Fax:
Practice Address - Street 1:20 LOOKOUT DR
Practice Address - Street 2:
Practice Address - City:EUFAULA
Practice Address - State:AL
Practice Address - Zip Code:36027-4845
Practice Address - Country:US
Practice Address - Phone:334-441-9922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-27
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0029937524Medicaid