Provider Demographics
NPI:1285036749
Name:HANNA, RACHEL KIRSTIN (RN)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:KIRSTIN
Last Name:HANNA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4857 VIOLET LN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53714-2126
Mailing Address - Country:US
Mailing Address - Phone:608-963-6867
Mailing Address - Fax:
Practice Address - Street 1:4857 VIOLET LN
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53714-2126
Practice Address - Country:US
Practice Address - Phone:608-963-6867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI154837-30163W00000X, 163WM0705X, 163WN0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care
No163W00000XNursing Service ProvidersRegistered Nurse
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical