Provider Demographics
NPI:1861420127
Name:HILLMAN, MARCIA L (ARNP)
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:L
Last Name:HILLMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2101 KIMBALL AVE
Mailing Address - Street 2:LL14
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702-5063
Mailing Address - Country:US
Mailing Address - Phone:319-272-1590
Mailing Address - Fax:319-272-1535
Practice Address - Street 1:226 BLUEBELL RD
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-6328
Practice Address - Country:US
Practice Address - Phone:319-575-5889
Practice Address - Fax:319-575-5855
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IAA074551363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA5479261Medicaid
IA5479261Medicaid
IAI16799Medicare PIN