Healthcare Provider Details

I. General information

NPI: 1710185756
Provider Name (Legal Business Name): STEPHANIE HILLERS RN, MSN, AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W NEW RD
GREENFIELD IN
46140-3001
US

IV. Provider business mailing address

400 W NEW RD
GREENFIELD IN
46140-3001
US

V. Phone/Fax

Practice location:
  • Phone: 317-467-8275
  • Fax: 855-811-4204
Mailing address:
  • Phone: 317-467-8275
  • Fax: 855-811-4204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28165299A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number28165299A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number28165299A
License Number StateIN
# 4
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number28165299A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: