Provider Demographics
NPI:1619751716
Name:WEGAND, HANNAH MAE
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:MAE
Last Name:WEGAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1273 ELM ST NW
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304-4019
Mailing Address - Country:US
Mailing Address - Phone:541-801-1763
Mailing Address - Fax:
Practice Address - Street 1:1273 ELM ST NW
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97304-4019
Practice Address - Country:US
Practice Address - Phone:541-801-1763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No374J00000XNursing Service Related ProvidersDoula