Healthcare Provider Details

I. General information

NPI: 1316317811
Provider Name (Legal Business Name): MICHAEL ALLEN HILAND F.N.P. - B.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2015
Last Update Date: 10/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8888 KEYSTONE XING STE 1300
INDIANAPOLIS IN
46240-4600
US

IV. Provider business mailing address

8888 KEYSTONE XING STE 1300
INDIANAPOLIS IN
46240-4600
US

V. Phone/Fax

Practice location:
  • Phone: 866-460-3567
  • Fax: 855-632-8329
Mailing address:
  • Phone: 866-460-3567
  • Fax: 855-632-8329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71005885A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: