1174781959 NPI number — DR. CHRISTINE GABRIELE HAHN M.D.

Table of content: DR. CHRISTINE GABRIELE HAHN M.D. (NPI 1174781959)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174781959 NPI number — DR. CHRISTINE GABRIELE HAHN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAHN
Provider First Name:
CHRISTINE
Provider Middle Name:
GABRIELE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

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:
1174781959
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/28/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 83720
Provider Second Line Business Mailing Address:
450 W. STATE ST., 4TH FLOOR
Provider Business Mailing Address City Name:
BOISE
Provider Business Mailing Address State Name:
ID
Provider Business Mailing Address Postal Code:
83720-0003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
208-334-5939
Provider Business Mailing Address Fax Number:
208-332-7307

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
450 W STATE ST
Provider Second Line Business Practice Location Address:
4TH FLOOR
Provider Business Practice Location Address City Name:
BOISE
Provider Business Practice Location Address State Name:
ID
Provider Business Practice Location Address Postal Code:
83702-6056
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
208-334-5939
Provider Business Practice Location Address Fax Number:
208-332-7307
Provider Enumeration Date:
05/28/2008

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: 207RI0200X , with the licence number:  M-7125 , registered in the state of ID ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com