Healthcare Provider Details

I. General information

NPI: 1538294657
Provider Name (Legal Business Name): LOUANN HILLEBRAND APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 07/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1705 NW 6TH STREET
GAINESVILLE FL
32609-3531
US

IV. Provider business mailing address

1705 NW 6TH STREET
GAINESVILLE FL
32609-3531
US

V. Phone/Fax

Practice location:
  • Phone: 352-505-5581
  • Fax: 352-378-5166
Mailing address:
  • Phone: 352-505-5581
  • Fax: 352-378-5166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberARNP731722
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number731722
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: