Basic Information
| Provider Information | |||||||||
| NPI: | 1174190516 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HILSON | ||||||||
| FirstName: | JASMINE | ||||||||
| MiddleName: | BIANCA-SYMONE | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1751 VETERANS DR STE 300 | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 356304930 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567183200 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1751 VETERANS DR STE 300 | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 356304930 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567183200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2021 | ||||||||
| LastUpdateDate: | 08/02/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | 1805 | AL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.