Provider Demographics
NPI:1073762597
Name:WILLE, HILDE (RN)
Entity Type:Individual
Prefix:MRS
First Name:HILDE
Middle Name:
Last Name:WILLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:HILDE
Other - Middle Name:
Other - Last Name:VAN DER MERWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8226 INNSDALE AVE S
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55016-3293
Mailing Address - Country:US
Mailing Address - Phone:651-306-2072
Mailing Address - Fax:
Practice Address - Street 1:8226 INNSDALE AVE S
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55016-3293
Practice Address - Country:US
Practice Address - Phone:651-306-2072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR176954-4163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health