Provider Demographics
NPI:1871659938
Name:HILDRETH, JANET KAY (FN P)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:KAY
Last Name:HILDRETH
Suffix:
Gender:F
Credentials:FN P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20985 VIA SIERRA CT
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-9500
Mailing Address - Country:US
Mailing Address - Phone:541-383-0124
Mailing Address - Fax:541-382-1440
Practice Address - Street 1:2577 NE COURTNEY DR
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-7638
Practice Address - Country:US
Practice Address - Phone:541-322-7445
Practice Address - Fax:541-382-1440
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR000024240N1 FNP PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily