Basic Information
Provider Information
NPI: 1003149790
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CROSS-HILLMAN
FirstName: NICOLE
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: PSY.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: CROSS
OtherFirstName: NICOLE
OtherMiddleName: L
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 5074
Address2:  
City: SIOUX FALLS
State: SD
PostalCode: 571175074
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 414 N 7TH ST
Address2:  
City: BISMARCK
State: ND
PostalCode: 585014423
CountryCode: US
TelephoneNumber: 7013236543
FaxNumber: 7013236960
Other Information
ProviderEnumerationDate: 09/11/2009
LastUpdateDate: 10/09/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103T00000X479NDY Behavioral Health & Social Service ProvidersPsychologist 
103TC0700X479NDN Behavioral Health & Social Service ProvidersPsychologistClinical
103TC0700XLP 5446MNN Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


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