Provider Demographics
NPI:1437602729
Name:HANRAHAN, CHRISTIE ANN (AGPCNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTIE
Middle Name:ANN
Last Name:HANRAHAN
Suffix:
Gender:F
Credentials:AGPCNP-BC
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Mailing Address - Street 1:2801 W KINNICKINNIC RIVER PKWY
Mailing Address - Street 2:STE 370
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-3669
Mailing Address - Country:US
Mailing Address - Phone:414-649-1280
Mailing Address - Fax:414-649-1288
Practice Address - Street 1:2801 W KINNICKINNIC RIVER PKWY
Practice Address - Street 2:STE 370
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-3669
Practice Address - Country:US
Practice Address - Phone:414-649-1280
Practice Address - Fax:414-649-1288
Is Sole Proprietor?:No
Enumeration Date:2016-08-03
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI7134-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1437602729Medicaid
WIK400325373Medicare PIN