Healthcare Provider Details

I. General information

NPI: 1043174956
Provider Name (Legal Business Name): HANNAH CHRISTINE DEAN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2757 LEONARD ST NE STE 300
GRAND RAPIDS MI
49525-5807
US

IV. Provider business mailing address

2757 LEONARD ST NE STE 300
GRAND RAPIDS MI
49525-5807
US

V. Phone/Fax

Practice location:
  • Phone: 616-942-6687
  • Fax:
Mailing address:
  • Phone: 616-942-6687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: