Provider Demographics
NPI:1366274375
Name:GRAPHENTEEN, HANNAH LE (FNP-C)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:LE
Last Name:GRAPHENTEEN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:LE
Other - Last Name:SCHARPEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3141 IDAHO AVE N
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL
Mailing Address - State:MN
Mailing Address - Zip Code:55427-2930
Mailing Address - Country:US
Mailing Address - Phone:612-669-9132
Mailing Address - Fax:
Practice Address - Street 1:3141 IDAHO AVE N
Practice Address - Street 2:
Practice Address - City:CRYSTAL
Practice Address - State:MN
Practice Address - Zip Code:55427-2930
Practice Address - Country:US
Practice Address - Phone:612-669-9132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ303891207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty