Provider Demographics
NPI:1104665108
Name:HILLERY, PAMELA (RN, HEALTH COACH)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:HILLERY
Suffix:
Gender:F
Credentials:RN, HEALTH COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 AMHERST DR APT 2057
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-1952
Mailing Address - Country:US
Mailing Address - Phone:817-739-4059
Mailing Address - Fax:
Practice Address - Street 1:1113 AMHERST DR APT 2057
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-1952
Practice Address - Country:US
Practice Address - Phone:817-739-4059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach