Healthcare Provider Details

I. General information

NPI: 1639731656
Provider Name (Legal Business Name): JESSICA LAUREN HILDERBRAND MSN, NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA LAUREN KLEIN APRN-CNP

II. Dates (important events)

Enumeration Date: 06/29/2019
Last Update Date: 12/18/2019
Certification Date: 12/18/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVE
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4466
  • Fax:
Mailing address:
  • Phone: 513-636-4466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License NumberRN.402477
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberAPRN.CNP.026033
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.026033
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: