Kelly Lashawn Hillmer
Individual provider Active NPI Contractor · North Las Vegas, NV
NPI 1104240969 · NPPES record last updated Feb 13, 2014
Key facts
- NPI
- 1104240969
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- 46-4790140 (NV)
- Practice address
- 1309 Heather Ridge Rd
North Las Vegas, NV 89031-1523 - Phone
- (702) 273-0301
- NPI assigned
- Feb 13, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46-4790140 | NV | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 46-4790140 | NV | Yes |
Addresses
Primary practice location
1309 Heather Ridge Rd
North Las Vegas, NV 89031-1523
Mailing address
1309 Heather Ridge Rd
North Las Vegas, NV 89031-1523
Phone (702) 273-0301
Other providers in North Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.