Individual
TANYA HILLIARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.P.N.P.
Contact information
Practice address
2525 CHICAGO AVE, MS CSC 525, MINNEAPOLIS, MN 55404-4518
(612) 813-8618
(612) 813-8624
Mailing address
2525 CHICAGO AVE, MS CSC 525, MINNEAPOLIS, MN 55404-4518
(612) 813-8618
(612) 813-8624
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R140940-6
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
520089000
—
MN
Enumeration date
08/22/2005
Last updated
10/19/2015
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