Provider Demographics
NPI:1023547486
Name:DEVRIES, HANNAH STATZ (MD)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:STATZ
Last Name:DEVRIES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:GRACE
Other - Last Name:STATZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4400 W 69TH ST STE 1500
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-8171
Mailing Address - Country:US
Mailing Address - Phone:605-322-5700
Mailing Address - Fax:
Practice Address - Street 1:4400 W 69TH ST STE 1500
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-8171
Practice Address - Country:US
Practice Address - Phone:605-322-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1250700572084P0802X
SD133032084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry