Healthcare Provider Details

I. General information

NPI: 1124442660
Provider Name (Legal Business Name): HILARY BRANNEN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HILARY WELSH RN

II. Dates (important events)

Enumeration Date: 02/04/2014
Last Update Date: 08/07/2021
Certification Date: 08/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

699 FARMHOUSE LN
BOZEMAN MT
59715-9402
US

IV. Provider business mailing address

699 FARMHOUSE LN
BOZEMAN MT
59715-9402
US

V. Phone/Fax

Practice location:
  • Phone: 406-556-6500
  • Fax:
Mailing address:
  • Phone: 406-556-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNUR-APRN-LIC-176101
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number71207
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: