Healthcare Provider Details

I. General information

NPI: 1265587976
Provider Name (Legal Business Name): TERRI A HAHN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 05/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

824 ILLINOIS AVE
STEVENS POINT WI
54481-3112
US

IV. Provider business mailing address

900 ILLINOIS AVE
STEVENS POINT WI
54481-3114
US

V. Phone/Fax

Practice location:
  • Phone: 715-342-7500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number40659
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number40659
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: