Provider Demographics
NPI:1205901634
Name:HILDNER, JOANNE ANDERSON (PA-C)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:ANDERSON
Last Name:HILDNER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3004 BRIDGES ST
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-3330
Mailing Address - Country:US
Mailing Address - Phone:252-727-4933
Mailing Address - Fax:252-727-4936
Practice Address - Street 1:3004 BRIDGES ST
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-3330
Practice Address - Country:US
Practice Address - Phone:252-727-4933
Practice Address - Fax:252-727-4936
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-00730363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCQ76993Medicare UPIN
NC2767554Medicare PIN