Provider Demographics
NPI:1952895245
Name:HILK, NICHOLE SUZANNE (OD)
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:SUZANNE
Last Name:HILK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:NICHOLE
Other - Middle Name:SUZANNE
Other - Last Name:CONLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:451 FAIROAKS DR
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638-6103
Mailing Address - Country:US
Mailing Address - Phone:989-780-2661
Mailing Address - Fax:
Practice Address - Street 1:105 W EXCHANGE ST
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:MI
Practice Address - Zip Code:49456-2024
Practice Address - Country:US
Practice Address - Phone:616-844-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901005126152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist