Provider Demographics
NPI:1467164277
Name:BALDER, HANNAH MARIE (APRN CNP)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:MARIE
Last Name:BALDER
Suffix:
Gender:F
Credentials:APRN CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2647 GREENMEADOW CT
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-5406
Mailing Address - Country:US
Mailing Address - Phone:612-735-4135
Mailing Address - Fax:
Practice Address - Street 1:2535 UNIVERSITY AVE SE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414-3205
Practice Address - Country:US
Practice Address - Phone:612-672-2350
Practice Address - Fax:612-672-1827
Is Sole Proprietor?:No
Enumeration Date:2022-12-23
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9617208000000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics