Provider Demographics
NPI:1487980710
Name:HILDEBRANDT, RANA HADDEN (FNP)
Entity type:Individual
Prefix:
First Name:RANA
Middle Name:HADDEN
Last Name:HILDEBRANDT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 OKATIE CENTER BLVD S STE 101
Mailing Address - Street 2:
Mailing Address - City:OKATIE
Mailing Address - State:SC
Mailing Address - Zip Code:29909-7506
Mailing Address - Country:US
Mailing Address - Phone:843-836-3800
Mailing Address - Fax:843-705-3828
Practice Address - Street 1:14 OKATIE CENTER BLVD S STE 101
Practice Address - Street 2:
Practice Address - City:OKATIE
Practice Address - State:SC
Practice Address - Zip Code:29909
Practice Address - Country:US
Practice Address - Phone:843-836-3800
Practice Address - Fax:843-705-3828
Is Sole Proprietor?:No
Enumeration Date:2009-10-21
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN152808363LF0000X
SC19363363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP01133812OtherRAILROAD MEDICARE
GA003109076DMedicaid
GA003109076CMedicaid
GA003109076CMedicaid