1306577648 NPI number — MRS. HILARY JANE MCCANN PMHNP-BC, APRN

Table of content: MRS. HILARY JANE MCCANN PMHNP-BC, APRN (NPI 1306577648)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306577648 NPI number — MRS. HILARY JANE MCCANN PMHNP-BC, APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCCANN
Provider First Name:
HILARY
Provider Middle Name:
JANE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PMHNP-BC, APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BURYANEK
Provider Other First Name:
HILARY
Provider Other Middle Name:
JANE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PMHNP-BC, ARNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1306577648
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/27/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6508 S AUDIE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SIOUX FALLS
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57108
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-680-4037
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
MED RX PARTNERS
Provider Second Line Business Practice Location Address:
5512 NORTHEAST 109TH COURT SUITE I
Provider Business Practice Location Address City Name:
VANCOUVER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98662
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-200-5273
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/17/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X , with the licence number:  202214151NP-PP , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: AP1321870 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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