Basic Information
| Provider Information | |||||||||
| NPI: | 1750048179 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HILDEN | ||||||||
| FirstName: | DANA | ||||||||
| MiddleName: | N | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 56934 MANOR CT | ||||||||
| Address2: | |||||||||
| City: | SHELBY TWP | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483164824 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5862429120 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7030 WHITMORE LAKE RD | ||||||||
| Address2: | |||||||||
| City: | BRIGHTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481168533 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2484863636 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/19/2021 | ||||||||
| LastUpdateDate: | 11/19/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 4704303281 | MI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 1073780573 | 01 | NPI NUMBER | OTHER |