Provider Demographics
NPI:1629885074
Name:GIETZEN, HANNAH M (DSP)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:M
Last Name:GIETZEN
Suffix:
Gender:F
Credentials:DSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-5853
Mailing Address - Country:US
Mailing Address - Phone:701-220-6252
Mailing Address - Fax:
Practice Address - Street 1:1003 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504-5853
Practice Address - Country:US
Practice Address - Phone:701-220-6252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant