Provider Demographics
NPI:1629465695
Name:RAYNOR, HANNAH (MD)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:RAYNOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 UNIVERSITY AVE
Mailing Address - Street 2:APT 107
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-2100
Mailing Address - Country:US
Mailing Address - Phone:715-651-2559
Mailing Address - Fax:
Practice Address - Street 1:1919 LINCOLN WAY
Practice Address - Street 2:SUITE 315
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2527
Practice Address - Country:US
Practice Address - Phone:208-625-4255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program