Provider Demographics
NPI:1487914677
Name:HILTON, MARIE G (LVN)
Entity type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:G
Last Name:HILTON
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6860 DIAMOND DR
Mailing Address - Street 2:
Mailing Address - City:POLLOCK PINES
Mailing Address - State:CA
Mailing Address - Zip Code:95726-9594
Mailing Address - Country:US
Mailing Address - Phone:530-559-3188
Mailing Address - Fax:
Practice Address - Street 1:6860 DIAMOND DR
Practice Address - Street 2:
Practice Address - City:POLLOCK PINES
Practice Address - State:CA
Practice Address - Zip Code:95726-9594
Practice Address - Country:US
Practice Address - Phone:530-559-3188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 189087164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse