Provider Demographics
NPI:1336854553
Name:HILTON, MARY LIZETTE (RN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:LIZETTE
Last Name:HILTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28096 SILVERBELL DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-5262
Mailing Address - Country:US
Mailing Address - Phone:586-260-5703
Mailing Address - Fax:
Practice Address - Street 1:28096 SILVERBELL DR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-5262
Practice Address - Country:US
Practice Address - Phone:586-260-5703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704214457163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse