MEDICARE: HANNAH MINNICK RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN500023845	MD
2	163W00000X	Registered Nurse	R264555	MD

General Provider Information

NPI Number	:	1790659522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH MINNICK RN

Provider Business Mailing Address
First Line	:	225 N CALVERT ST APT 1411
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21202-4957
Country	:	US
Telephone Number	:	240-755-4682
Fax Number	:

Provider Business Practice Location Address
First Line	:	9512 HARFORD RD STE 4
Second Line	:
City	:	PARKVILLE
State	:	MD
Zip	:	21234-3127
Country	:	US
Telephone Number	:	410-665-4400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2025
Last Update Date	:	10/03/2025

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