Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | 6534 | MN |
Y | 213ER0200X | Radiology | 6534 | MN |
NPI | 1447727011 |
---|---|
Provider Name | Hannah Pick |
First Address | Saint Paul Park, MN 55071-1809 |
Second Address | Hastings, MN 55033-3605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2018 |
Last Update Date | 27/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
412012721 | (05) | MN |