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: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5571 GOLDEN GATE WAY
KOKOMO IN
46902-5651
US

IV. Provider business mailing address

5571 GOLDEN GATE WAY
KOKOMO IN
46902-5651
US

V. Phone/Fax

Practice location:
  • Phone: 765-480-4715
  • Fax:
Mailing address:
  • Phone: 765-480-4715
  • Fax:

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: