Provider Demographics
NPI:1821883000
Name:MALONEY, HILLARY (PA-C)
Entity type:Individual
Prefix:
First Name:HILLARY
Middle Name:
Last Name:MALONEY
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 W CROSSVILLE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-7520
Mailing Address - Country:US
Mailing Address - Phone:678-878-3045
Mailing Address - Fax:
Practice Address - Street 1:640 W CROSSVILLE RD STE 300
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-7520
Practice Address - Country:US
Practice Address - Phone:678-878-3045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-10
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA13020363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant