Healthcare Provider Details

I. General information

NPI: 1881272110
Provider Name (Legal Business Name): HANNAH JANE CUSHEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 DELAWARE ST SE
MINNEAPOLIS MN
55455-0341
US

IV. Provider business mailing address

8445 WINNETKA HEIGHTS DR
GOLDEN VALLEY MN
55427-3316
US

V. Phone/Fax

Practice location:
  • Phone: 612-624-0990
  • Fax: 612-625-3238
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number77233
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: