1255902177 NPI number — HANNAH VANOCHTEN PHARMD

Table of content: HANNAH VANOCHTEN PHARMD (NPI 1255902177)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255902177 NPI number — HANNAH VANOCHTEN PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VANOCHTEN
Provider First Name:
HANNAH
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
VAN OCHTEN
Provider Other First Name:
HANNAH
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHARMD
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1255902177
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/14/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19825 SWEETWATER CURV
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHOREWOOD
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55331-8123
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
952-807-3763
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
760 HARRISON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN FRANCISCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94107-1235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-836-1700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/02/2021

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 183500000X , with the licence number: 84858 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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