Healthcare Provider Details
I. General information
NPI: 1174305767
Provider Name (Legal Business Name): ALINA GABRIELA HANAK PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/18/2023
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
350 PINE ST
RAPID CITY SD
57701-1669
US
IV. Provider business mailing address
350 PINE ST
RAPID CITY SD
57701-1669
US
V. Phone/Fax
- Phone: 605-721-8939
- Fax: 605-721-8998
- Phone: 605-721-8939
- Fax: 605-721-8998
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 2023153062 |
| License Number State | SD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: