Healthcare Provider Details

I. General information

NPI: 1972959823
Provider Name (Legal Business Name): KAITLIN D. HAHN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAITLIN D. ZENTIC

II. Dates (important events)

Enumeration Date: 05/10/2016
Last Update Date: 09/01/2020
Certification Date: 09/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1113 SHERMAN ST
SAINT PAUL NE
68873-1546
US

IV. Provider business mailing address

PO BOX 406
SAINT PAUL NE
68873-0406
US

V. Phone/Fax

Practice location:
  • Phone: 308-754-4421
  • Fax: 308-754-2303
Mailing address:
  • Phone: 308-754-4421
  • Fax: 308-754-2303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number7637
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: