Provider Demographics
NPI:1669655023
Name:HILDERBRAND, SHEILAH GAIL
Entity Type:Individual
Prefix:
First Name:SHEILAH
Middle Name:GAIL
Last Name:HILDERBRAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38789 KOOPMAN LN
Mailing Address - Street 2:P. O. BOX 711
Mailing Address - City:HALFWAY
Mailing Address - State:OR
Mailing Address - Zip Code:97834-8113
Mailing Address - Country:US
Mailing Address - Phone:541-540-1367
Mailing Address - Fax:
Practice Address - Street 1:38789 KOOPMAN LN
Practice Address - Street 2:
Practice Address - City:HALFWAY
Practice Address - State:OR
Practice Address - Zip Code:97834-8113
Practice Address - Country:US
Practice Address - Phone:541-540-1367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-07
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health