Healthcare Provider Details

I. General information

NPI: 1801314802
Provider Name (Legal Business Name): CASEY MARIE HILLENBRAND APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2017
Last Update Date: 09/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2072 N COUNTY ROAD 700 W
RICHLAND IN
47634-9480
US

IV. Provider business mailing address

13540 DARMSTADT RD
EVANSVILLE IN
47725-9549
US

V. Phone/Fax

Practice location:
  • Phone: 812-359-4012
  • Fax:
Mailing address:
  • Phone: 812-205-4315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number71007513A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: