Provider Demographics
NPI:1831704170
Name:HILLMANN, LISA (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:HILLMANN
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 YELLOWOOD LN
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-7401
Mailing Address - Country:US
Mailing Address - Phone:614-886-5472
Mailing Address - Fax:
Practice Address - Street 1:302 YELLOWOOD LN
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-7401
Practice Address - Country:US
Practice Address - Phone:614-886-5472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-14
Last Update Date:2021-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL006384133V00000X
OHLD.09187133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered