Basic Information
| Provider Information | |||||||||
| NPI: | 1861144008 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BILLHIME | ||||||||
| FirstName: | NINA | ||||||||
| MiddleName: | MARIE EDKIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2399 N OLD TRL | ||||||||
| Address2: | |||||||||
| City: | SELINSGROVE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178707762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5708095766 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9 BANKS AVE | ||||||||
| Address2: | |||||||||
| City: | MCADOO | ||||||||
| State: | PA | ||||||||
| PostalCode: | 182372508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8887264774 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2022 | ||||||||
| LastUpdateDate: | 01/25/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | PA | Y |
No ID Information.