Individual
JACI RAE HANNASCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
300 S BRUCE ST, MARSHALL, MN 56258-1934
(507) 532-9661
Mailing address
507 MERCEDES DR, MARSHALL, MN 56258-5497
(605) 360-6046
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
8803
MN
Other
Enumeration date
12/02/2021
Last updated
01/03/2022
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