Provider Demographics
NPI:1568354504
Name:HILTY, JESSICA MAE (OD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MAE
Last Name:HILTY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 W SILVER CREEK CT
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-5295
Mailing Address - Country:US
Mailing Address - Phone:716-237-0314
Mailing Address - Fax:
Practice Address - Street 1:291 N MILWAUKEE ST STE A-3
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-9132
Practice Address - Country:US
Practice Address - Phone:208-378-7020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID5871067152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist