Healthcare Provider Details

I. General information

NPI: 1487741484
Provider Name (Legal Business Name): CARLA J HILDEBRANDT-FOLSKE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARLA J FOLSKE CRNA

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 05/03/2022
Certification Date: 05/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 E GREENFIELD LN
BISMARCK ND
58503-6578
US

IV. Provider business mailing address

106 E GREENFIELD LN
BISMARCK ND
58503-6578
US

V. Phone/Fax

Practice location:
  • Phone: 701-354-4744
  • Fax: 701-323-3377
Mailing address:
  • Phone: 701-354-4744
  • Fax: 701-222-8805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR27481
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: