Healthcare Provider Details

I. General information

NPI: 1609531177
Provider Name (Legal Business Name): HANNAH GRACE MEISSNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2021
Last Update Date: 11/01/2021
Certification Date: 11/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 W MICHIGAN AVE APT 1
YPSILANTI MI
48197-5316
US

IV. Provider business mailing address

1121 E MCNICHOLS RD
DETROIT MI
48203-2857
US

V. Phone/Fax

Practice location:
  • Phone: 734-686-5690
  • Fax:
Mailing address:
  • Phone: 313-365-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: