Individual
DR. HANNAH MOUSSA VINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1705 ANNE ST NW, BEMIDJI, MN 56601-6151
(218) 333-4820
Mailing address
1705 ANNE ST NW, BEMIDJI, MN 56601-6151
(218) 333-4820
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
76111
MN
2084P0800X
Psychiatry Physician
BP10025329
TX
2084P0800X
Psychiatry Physician
N0297
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16158199
TEXAS DRIVERS LICENSE
TX
01
—
530763090
US PASSPORT
—
01
—
D000-131-670-900
MINNESOTA DRIVERS LICENSE
MN
Enumeration date
05/11/2007
Last updated
09/15/2025
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