Provider Demographics
NPI:1639978190
Name:HILDEBRAND, LOLA
Entity type:Individual
Prefix:
First Name:LOLA
Middle Name:
Last Name:HILDEBRAND
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRIEND
Mailing Address - State:NE
Mailing Address - Zip Code:68359-1348
Mailing Address - Country:US
Mailing Address - Phone:531-739-9223
Mailing Address - Fax:
Practice Address - Street 1:404 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FRIEND
Practice Address - State:NE
Practice Address - Zip Code:68359-1348
Practice Address - Country:US
Practice Address - Phone:531-739-9223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child