Provider Demographics
NPI:1790659522
Name:MINNICK, HANNAH (RN)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:MINNICK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 N CALVERT ST APT 1411
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-4957
Mailing Address - Country:US
Mailing Address - Phone:240-755-4682
Mailing Address - Fax:
Practice Address - Street 1:9512 HARFORD RD STE 4
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-3127
Practice Address - Country:US
Practice Address - Phone:410-665-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-03
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRN500023845163W00000X
MDR264555163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse