Provider Demographics
NPI:1083837413
Name:UPRIGHT, HANA O (NP)
Entity Type:Individual
Prefix:
First Name:HANA
Middle Name:O
Last Name:UPRIGHT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:HANA
Other - Middle Name:O
Other - Last Name:ASSAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 735044
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-5044
Mailing Address - Country:US
Mailing Address - Phone:262-642-2000
Mailing Address - Fax:
Practice Address - Street 1:2483 CORPORATE CIR
Practice Address - Street 2:
Practice Address - City:EAST TROY
Practice Address - State:WI
Practice Address - Zip Code:53120-2575
Practice Address - Country:US
Practice Address - Phone:262-642-2000
Practice Address - Fax:262-642-2143
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3077363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI36030300Medicaid
WI2006005631-22OtherANCC CERTIFICATE