Provider Demographics
NPI:1245204668
Name:HAHN, PAMELA DAWN (DC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:DAWN
Last Name:HAHN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 W SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:ELDRIDGE
Mailing Address - State:IA
Mailing Address - Zip Code:52748-1177
Mailing Address - Country:US
Mailing Address - Phone:563-249-0056
Mailing Address - Fax:
Practice Address - Street 1:209 W FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:ELDRIDGE
Practice Address - State:IA
Practice Address - Zip Code:52748-1241
Practice Address - Country:US
Practice Address - Phone:563-249-0056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06610111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA34544OtherBLUE CROSS BLUE SHIELD
IA34544OtherBLUE CROSS BLUE SHIELD