Provider Demographics
NPI:1316317811
Name:HILAND, MICHAEL ALLEN (FNP - BC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ALLEN
Last Name:HILAND
Suffix:
Gender:M
Credentials:FNP - BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8888 KEYSTONE XING STE 1300
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-4600
Mailing Address - Country:US
Mailing Address - Phone:866-460-3567
Mailing Address - Fax:855-632-8329
Practice Address - Street 1:8888 KEYSTONE XING STE 1300
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-4600
Practice Address - Country:US
Practice Address - Phone:866-460-3567
Practice Address - Fax:855-632-8329
Is Sole Proprietor?:No
Enumeration Date:2015-09-28
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71005885A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily