Provider Demographics
NPI:1811789803
Name:EHRENBERG, HANNA MARIE
Entity type:Individual
Prefix:
First Name:HANNA
Middle Name:MARIE
Last Name:EHRENBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HANNA
Other - Middle Name:MARIE
Other - Last Name:VOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1330 93RD ST
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-5014
Mailing Address - Country:US
Mailing Address - Phone:641-660-6500
Mailing Address - Fax:
Practice Address - Street 1:1801 HICKMAN RD
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-1597
Practice Address - Country:US
Practice Address - Phone:515-282-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-13541207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine