Healthcare Provider Details

I. General information

NPI: 1548072002
Provider Name (Legal Business Name): KATHERINE ELAINE HANNA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2025
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 3RD ST NW UNIT 102
GREAT FALLS MT
59404-4115
US

IV. Provider business mailing address

524 FOX CT
GREAT FALLS MT
59404-3874
US

V. Phone/Fax

Practice location:
  • Phone: 833-750-0637
  • Fax: 406-365-1424
Mailing address:
  • Phone: 978-764-4113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0039821
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.525518
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: