Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | MD20772 | ME |
NPI | 1063575355 |
---|---|
Provider Name | Dr. Kathryn Heidi Hanna |
First Address | South Portland, ME 04106-3270 |
Second Address | Portland, ME 04102-2603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 09/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1063575355 | (05) | ME |