Provider Demographics
NPI:1154137834
Name:HILAND, KAILEY MARIE
Entity type:Individual
Prefix:
First Name:KAILEY
Middle Name:MARIE
Last Name:HILAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 MAYFIELD AVE APT A
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-6086
Mailing Address - Country:US
Mailing Address - Phone:219-776-9594
Mailing Address - Fax:
Practice Address - Street 1:8398 MISSISSIPPI ST
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6316
Practice Address - Country:US
Practice Address - Phone:219-755-4049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist