1528100567 NPI number — MARK HANNAPPEL PH.D.

Table of content: MARK HANNAPPEL PH.D. (NPI 1528100567)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528100567 NPI number — MARK HANNAPPEL PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HANNAPPEL
Provider First Name:
MARK
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528100567
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/22/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1306 ANDREWS DR
Provider Second Line Business Mailing Address:
P.O. BOX 1163
Provider Business Mailing Address City Name:
NORFOLK
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68701-2760
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-851-4026
Provider Business Mailing Address Fax Number:
402-379-2487

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1306 ANDREWS DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORFOLK
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-851-4026
Provider Business Practice Location Address Fax Number:
402-379-2487
Provider Enumeration Date:
02/13/2007

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: 103T00000X , with the licence number:  379 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 817 . This is a "MIDLANDS CHOICE IND. #" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 08103 . This is a "BCBS IND. PROVIDER #" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 47084203426 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6160552 . This is a "UBH IND. PROVIDER #" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".




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