Healthcare Provider Details

I. General information

NPI: 1922783620
Provider Name (Legal Business Name): HANNAH MARJORIE DISINGER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2023
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39729 580TH AVE
APPLETON MN
56208-1900
US

IV. Provider business mailing address

400 E 3RD ST
DULUTH MN
55805-1951
US

V. Phone/Fax

Practice location:
  • Phone: 320-413-0335
  • Fax:
Mailing address:
  • Phone: 218-786-8364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number15305
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: