Provider Demographics
NPI:1649795527
Name:HILLMAN, KELLIE TERRELL (FNP-C)
Entity type:Individual
Prefix:
First Name:KELLIE
Middle Name:TERRELL
Last Name:HILLMAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 TERRELL LN
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:LA
Mailing Address - Zip Code:71225-8483
Mailing Address - Country:US
Mailing Address - Phone:318-537-5484
Mailing Address - Fax:
Practice Address - Street 1:205 TERRELL LN
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:LA
Practice Address - Zip Code:71225-8483
Practice Address - Country:US
Practice Address - Phone:318-537-5484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAF07171401363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care