Provider Demographics
NPI:1356772271
Name:HILLMAN, COURTNEY JORDAN (DNP, CPNP)
Entity type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:JORDAN
Last Name:HILLMAN
Suffix:
Gender:F
Credentials:DNP, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1871 SAVAGE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-4726
Mailing Address - Country:US
Mailing Address - Phone:843-766-6308
Mailing Address - Fax:843-804-9883
Practice Address - Street 1:1871 SAVAGE RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-4726
Practice Address - Country:US
Practice Address - Phone:843-766-6308
Practice Address - Fax:843-804-9883
Is Sole Proprietor?:No
Enumeration Date:2013-12-02
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18332363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSC22319223OtherMEDICARE PTAN
SCNP2802Medicaid
SC2231D062OtherPTAN