Active NPI
Debra Ann Hildenbrand, P.N.P.
- Nurse Practitioner
- Chanhassen, MN
National Provider Identifier
1649452962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 3610
- Practice address
- 300 Lake Dr E
Chanhassen, MN 55317-9302 - Phone
- (952) 993-4300
- NPI assigned
- Nov 28, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 3610 | MN | Primary |
| Pediatric Nurse Practitioner | 363LP0200X | R 126301-1 | MN |
Addresses
Primary practice location
300 Lake Dr E
Chanhassen, MN 55317-9302
Mailing address
8170 33Rd Ave S # Ms 21110Q
Bloomington, MN 55425-4516
Other practice location 1
5320 Hyland Greens Dr
Bloomington, MN 55437-3934
Phone (952) 993-2400
Other names 1
- Debra Ann Hipsag
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R 126301-1 | MN | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615334400000",
"number": "1649452962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8170 33RD AVE S # MS 21110Q",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554254516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 LAKE DR E",
"city": "CHANHASSEN",
"state": "MN",
"postal_code": "553179302",
"telephone_number": "952-993-4300"
}
],
"practiceLocations": [
{
"address_1": "5320 Hyland Greens Dr",
"address_purpose": "LOCATION",
"city": "Bloomington",
"state": "MN",
"postal_code": "554373934",
"country_code": "US",
"telephone_number": "952-993-2400",
"fax_number": "952-993-2522",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HILDENBRAND",
"first_name": "DEBRA",
"middle_name": "ANN",
"credential": "P.N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-28",
"last_updated": "2021-03-10",
"certification_date": "2021-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MN",
"license": "3610",
"primary": true
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MN",
"license": "R 126301-1",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DEBRA",
"last_name": "HIPSAG",
"middle_name": "ANN",
"code": "5",
"type": "Other Name"
}
]
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.