Provider Demographics
NPI:1760880066
Name:HILLENBRAND, CARLY JEAN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CARLY
Middle Name:JEAN
Last Name:HILLENBRAND
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MISS
Other - First Name:CARLY
Other - Middle Name:JEAN
Other - Last Name:MEEHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:520 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:ANACONDA
Mailing Address - State:MT
Mailing Address - Zip Code:59711-2851
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:118 E 7TH ST STE 3A
Practice Address - Street 2:
Practice Address - City:ANACONDA
Practice Address - State:MT
Practice Address - Zip Code:59711-2913
Practice Address - Country:US
Practice Address - Phone:406-209-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-18
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT47854163W00000X
MTNUR-APRN-LIC-103904363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse