Provider Demographics
NPI:1558150722
Name:HILLYARD, AMY LYNNE
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:LYNNE
Last Name:HILLYARD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7055 STATE HIGHWAY 58
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:NY
Mailing Address - Zip Code:13646-3345
Mailing Address - Country:US
Mailing Address - Phone:315-456-9022
Mailing Address - Fax:
Practice Address - Street 1:83 CLINTON ST
Practice Address - Street 2:
Practice Address - City:GOUVERNEUR
Practice Address - State:NY
Practice Address - Zip Code:13642-1039
Practice Address - Country:US
Practice Address - Phone:404-536-0898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider