Individual
STEPHANIE HILLYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1007 LINCOLNWAY, LA PORTE, IN 46350-3201
(219) 326-1234
Mailing address
1007 LINCOLNWAY, LA PORTE, IN 46350-3201
(219) 326-1234
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37002665A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
MEDICARE PTAN
IN
Enumeration date
09/16/2016
Last updated
09/16/2016
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