Provider Demographics
NPI:1427663921
Name:HILTY, ELLA J
Entity type:Individual
Prefix:
First Name:ELLA
Middle Name:J
Last Name:HILTY
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 1:8159 TOWNSHIP ROAD 565
Mailing Address - Street 2:
Mailing Address - City:HOLMESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44633-9705
Mailing Address - Country:US
Mailing Address - Phone:133-023-1096
Mailing Address - Fax:
Practice Address - Street 1:8159 TOWNSHIP ROAD 565
Practice Address - Street 2:
Practice Address - City:HOLMESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44633-9705
Practice Address - Country:US
Practice Address - Phone:133-023-1096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-11
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0343259Medicaid