Provider Demographics
NPI:1982666079
Name:HILDEBRAND, LAURA ORNOWSKI (ANP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ORNOWSKI
Last Name:HILDEBRAND
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1706 SAGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-2072
Mailing Address - Country:US
Mailing Address - Phone:970-219-6701
Mailing Address - Fax:
Practice Address - Street 1:1024 S LEMAY AVE
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3929
Practice Address - Country:US
Practice Address - Phone:970-624-1566
Practice Address - Fax:970-495-8316
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-04
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10295363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWNP16207AMedicare ID - Type UnspecifiedGROUP# W7168
CAQ61457Medicare UPIN