Provider Demographics
NPI:1417693656
Name:FAUPEL, HANNAH ELIZABETH (OD)
Entity Type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:ELIZABETH
Last Name:FAUPEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 BRANSON BAY DR
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:MI
Mailing Address - Zip Code:48854-9575
Mailing Address - Country:US
Mailing Address - Phone:517-231-5019
Mailing Address - Fax:
Practice Address - Street 1:2657 120TH AVE
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-8692
Practice Address - Country:US
Practice Address - Phone:616-395-0606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901005624APP22152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist