Provider Demographics
NPI:1154010528
Name:SANTOS, HANNAH (MS, LAT, ATC)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:SANTOS
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1751 COLETTE DR APT 4
Mailing Address - Street 2:
Mailing Address - City:NORTH MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56003-1959
Mailing Address - Country:US
Mailing Address - Phone:425-361-3868
Mailing Address - Fax:
Practice Address - Street 1:135 MYERS FIELDHOUSE
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-6171
Practice Address - Country:US
Practice Address - Phone:507-389-1243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN36582255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer