Healthcare Provider Details

I. General information

NPI: 1902450216
Provider Name (Legal Business Name): HANNA CLAIRE MIDDLEBROOK CNP, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2019
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 S 8TH ST
MINNEAPOLIS MN
55404-7530
US

IV. Provider business mailing address

701 PARK AVE
MINNEAPOLIS MN
55415-1623
US

V. Phone/Fax

Practice location:
  • Phone: 612-873-6963
  • Fax: 612-873-1928
Mailing address:
  • Phone: 612-873-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number6732
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: