Provider Demographics
NPI:1881078137
Name:ROBERSON, HILLARY A (PA-C)
Entity type:Individual
Prefix:
First Name:HILLARY
Middle Name:A
Last Name:ROBERSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HILLARY
Other - Middle Name:
Other - Last Name:BERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1848
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49443-1848
Mailing Address - Country:US
Mailing Address - Phone:231-672-8300
Mailing Address - Fax:231-672-8310
Practice Address - Street 1:1675 LEAHY ST STE 301
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-5543
Practice Address - Country:US
Practice Address - Phone:231-672-8300
Practice Address - Fax:231-672-8310
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601007352363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical