Individual
PAMELA OWEN HILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
109 1/2 4TH ST, BEAVER DAM, WI 53916-2051
(920) 791-0930
Mailing address
109 1/2 4TH ST, BEAVER DAM, WI 53916-2051
(920) 791-0930
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
32178-031
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38279700
—
WI
Enumeration date
09/10/2007
Last updated
10/04/2023
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