Provider Demographics
NPI:1689746141
Name:HAPP, ELAINE DONNA (OD)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:DONNA
Last Name:HAPP
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 1:560 CEDAR STREET
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:MN
Mailing Address - Zip Code:55362-8403
Mailing Address - Country:US
Mailing Address - Phone:763-271-2020
Mailing Address - Fax:763-271-2030
Practice Address - Street 1:560 CEDAR STREET
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:MN
Practice Address - Zip Code:55362-8403
Practice Address - Country:US
Practice Address - Phone:763-271-2020
Practice Address - Fax:763-271-2030
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2307152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN01012630OtherPREFERRED ONE
MNHP19238OtherHEALTH PARTNERS
411881402OtherTRI CARE
411881402OtherPATIENT CHOICE
MN5C210HAOtherBCBS
MN180325500Medicaid
411881402OtherAETNA
MN120626OtherU CARE
MN2201187OtherMEDICA
MN2201187OtherSELECT CARE
MN410042981OtherMEDICARE RAILROAD
MN180325500Medicaid
MN1187490001Medicare NSC
MN41000923Medicare ID - Type Unspecified