Provider Demographics
NPI:1255932877
Name:HILBERG, JULIE LYNN (PMHNP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:LYNN
Last Name:HILBERG
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4220 BROOKWAY LN
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:OH
Mailing Address - Zip Code:44144-1303
Mailing Address - Country:US
Mailing Address - Phone:216-269-7230
Mailing Address - Fax:
Practice Address - Street 1:4220 BROOKWAY LN
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:OH
Practice Address - Zip Code:44144-1303
Practice Address - Country:US
Practice Address - Phone:216-269-7230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-02
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0029885363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty