Provider Demographics
NPI:1568284586
Name:ENGUM, HILARY (RN)
Entity type:Individual
Prefix:
First Name:HILARY
Middle Name:
Last Name:ENGUM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 CLOTHESLINE RD
Mailing Address - Street 2:
Mailing Address - City:SHOSHONI
Mailing Address - State:WY
Mailing Address - Zip Code:82649-8625
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:511 N 12TH ST E
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:WY
Practice Address - Zip Code:82501-3805
Practice Address - Country:US
Practice Address - Phone:307-857-9281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY32128163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice