| Hanna Medical Clinic Sc | |
|
3207 Laura Ln Ste 105 Middleton WI 53562-1428 | |
| (608) 203-8022 | |
| (608) 203-8041 |
| Full Name | Hanna Medical Clinic Sc |
|---|---|
| Speciality | Family Medicine |
| Location | 3207 Laura Ln Ste 105, Middleton, Wisconsin |
| Authorized Official Name and Position | Nickolas Hanna (OWNER) |
| Authorized Official Contact | 6082088022 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hanna Medical Clinic Sc 3207 Laura Ln Ste 105 Middleton WI 53562-1428 Ph: (608) 203-8022 | Hanna Medical Clinic Sc 3207 Laura Ln Ste 105 Middleton WI 53562-1428 Ph: (608) 203-8022 |
| NPI Number | 1902342868 |
|---|---|
| Provider Enumeration Date | 01/16/2017 |
| Last Update Date | 11/08/2023 |
| Medicare PECOS PAC ID | 6901182955 |
|---|---|
| Medicare Enrollment ID | O20170406000676 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902342868 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 2083A0300X | Preventive Medicine - Addiction Medicine | (* (Not Available)) | Secondary |
| Provider Name | Nickolas F Hanna |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487732855 PECOS PAC ID: 7214002633 Enrollment ID: I20080820000287 |
| Provider Name | Jessica Seidel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689271801 PECOS PAC ID: 9234532482 Enrollment ID: I20210726001179 |
| Provider Name | Thomas Shane Bolan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770703431 PECOS PAC ID: 3577932656 Enrollment ID: I20221212002505 |
| Provider Name | Sarah Elizabeth Glomski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629434626 PECOS PAC ID: 7618328626 Enrollment ID: I20240103004044 |
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