Healthcare Provider Details

I. General information

NPI: 1720762933
Provider Name (Legal Business Name): HANNAH HILDAHL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2023
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5950 UNIVERSITY AVE STE 151
WEST DES MOINES IA
50266-8234
US

IV. Provider business mailing address

PO BOX 424
DES MOINES IA
50302-0424
US

V. Phone/Fax

Practice location:
  • Phone: 515-875-9192
  • Fax:
Mailing address:
  • Phone: 515-875-9178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD-55645
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: