Active NPI
Nina Dantzler Lillard, PMHCNS-BC
- Adult Psychiatric/Mental Health Clinical Nurse Specialist
- Hickory, NC
National Provider Identifier
1376783993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Psychiatric/Mental Health Clinical Nurse Specialist
- License
- 99155
- Practice address
- 858 2ND St NE
Hickory, NC 28601-3877 - Phone
- (828) 327-6633
- Fax
- (828) 327-3385
- NPI assigned
- Feb 22, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Psychiatric/Mental Health Clinical Nurse Specialist | 364SP0809X | 99155 | NC | Primary |
Addresses
Primary practice location
858 2ND St NE
Hickory, NC 28601-3877
Mailing address
858 2ND St NE
Hickory, NC 28601-3877
Phone (828) 327-6633
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6004039 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Specialist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 99155 | NC | MD | Adult Psychiatric/Mental Health Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277337600000",
"number": "1376783993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "858 2ND ST NE",
"city": "HICKORY",
"state": "NC",
"postal_code": "286013877",
"telephone_number": "828-327-6633",
"fax_number": "828-327-3385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "858 2ND ST NE",
"city": "HICKORY",
"state": "NC",
"postal_code": "286013877",
"telephone_number": "828-327-6633",
"fax_number": "828-327-3385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LILLARD",
"first_name": "NINA",
"middle_name": "DANTZLER",
"name_prefix": "Mrs.",
"credential": "PMHCNS-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-22",
"last_updated": "2010-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "364SP0809X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
"state": "NC",
"license": "99155",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6004039",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hickory, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.