Provider Demographics
NPI:1770161895
Name:LM HILTON HEALTH AND WELLNESS
Entity type:Organization
Organization Name:LM HILTON HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP-C/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAVENTRICE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HILTON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:704-534-2449
Mailing Address - Street 1:7209 E WT HARRIS BLVD
Mailing Address - Street 2:SUITE J, #228
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-7303
Mailing Address - Country:US
Mailing Address - Phone:704-534-2449
Mailing Address - Fax:
Practice Address - Street 1:7209 E WT HARRIS BLVD
Practice Address - Street 2:SUITE J, #228
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-7303
Practice Address - Country:US
Practice Address - Phone:704-672-5361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-30
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty