Provider Demographics
NPI:1386027910
Name:HANNEMAN, ANALISE JAMAICA (MD)
Entity Type:Individual
Prefix:
First Name:ANALISE
Middle Name:JAMAICA
Last Name:HANNEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANALISE
Other - Middle Name:JAMAICA
Other - Last Name:RUEGSEGGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11774 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-9592
Mailing Address - Country:US
Mailing Address - Phone:715-321-4558
Mailing Address - Fax:
Practice Address - Street 1:1000 N. OAK AVE.
Practice Address - Street 2:MARSHFIELD CLINIC
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449
Practice Address - Country:US
Practice Address - Phone:715-387-5600
Practice Address - Fax:715-389-3142
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-01
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI66292-20207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty