Provider Demographics
NPI:1861639205
Name:KULL, HANNAH L (APRN)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:L
Last Name:KULL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1397 SCHEFFER AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-2245
Mailing Address - Country:US
Mailing Address - Phone:913-544-6154
Mailing Address - Fax:
Practice Address - Street 1:1547 LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:WEST ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55118-3411
Practice Address - Country:US
Practice Address - Phone:651-726-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR192663-3363LF0000X
KS5346315062363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily