Provider Demographics
NPI:1427462258
Name:FYLPAA, HANNA RAE (OD)
Entity type:Individual
Prefix:DR
First Name:HANNA
Middle Name:RAE
Last Name:FYLPAA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:HANNA
Other - Middle Name:RAE
Other - Last Name:FROEHLICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:3200 CHANNEL DRIVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801
Mailing Address - Country:US
Mailing Address - Phone:907-463-4086
Mailing Address - Fax:907-463-6618
Practice Address - Street 1:3100 CHANNEL DR
Practice Address - Street 2:SUITE 300
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-7837
Practice Address - Country:US
Practice Address - Phone:907-463-4086
Practice Address - Fax:907-463-6618
Is Sole Proprietor?:No
Enumeration Date:2014-06-19
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3395152W00000X
AK105281152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist