Healthcare Provider Details

I. General information

NPI: 1821716440
Provider Name (Legal Business Name): HANNAH BRIANN KOHLER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2022
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 RIVER CENTRE DR
PORT HURON MI
48060-4463
US

IV. Provider business mailing address

1 OLD COURSE RD
SAINT CLAIR MI
48079-3588
US

V. Phone/Fax

Practice location:
  • Phone: 810-985-4900
  • Fax:
Mailing address:
  • Phone: 775-304-1789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704422018
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number856236
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: