Individual
WANDA HILLIARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC,APN
Contact information
Practice address
30 TECHNOLOGY DR, ROCKY MOUNT, VA 24151-3008
(540) 483-0582
Mailing address
9813 MEMORIAL BLVD, SUITE A, HUMBLE, TX 77338-4274
(281) 913-3550
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024178774
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
703524
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP119602
TX
Other
Enumeration date
12/14/2010
Last updated
06/04/2020
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