Healthcare Provider Details
I. General information
NPI: 1003556358
Provider Name (Legal Business Name): CARLY HILLENBRAND APRN
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/01/2022
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
118 E 7TH ST STE 3A
ANACONDA MT
59711-2913
US
IV. Provider business mailing address
520 SPRUCE ST
ANACONDA MT
59711-2851
US
V. Phone/Fax
- Phone: 406-209-7777
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CARLY
JEAN
HILLENBRAND
Title or Position: APRN, OWNER
Credential: APRN
Phone: 406-209-7777