Provider Demographics
NPI:1184222366
Name:HANN, VICTORIA
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:HANN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27600 HIGHWAY 1804
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:ND
Mailing Address - Zip Code:58521-9744
Mailing Address - Country:US
Mailing Address - Phone:732-439-6324
Mailing Address - Fax:
Practice Address - Street 1:27600 HIGHWAY 1804
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:ND
Practice Address - Zip Code:58521-9744
Practice Address - Country:US
Practice Address - Phone:732-439-6324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-11
Last Update Date:2020-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant