STEFANIE ULRIKE HANISCH (NPI# 1447350400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447350400 |
| Entity Type | Individual |
| Full Name | STEFANIE ULRIKE HANISCH |
| Credential | MD |
| Practice Address |
100 4th St S Fargo ND 58103-1929 |
| Practice Telephone | 7012344141 |
| Practice Fax Number | 7012344024 |
| Mailing Telephone | 7012344141 |
| Mailing Fax Number | 7012344024 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2016-12-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
9460 | ND | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
45431 | MN | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
9460 | ND | Allopathic & Osteopathic Physicians |
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
45431 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HEALTHPARTNERS | HP51767 | 01 | |
| ND | ND BCBS | 28773 | 01 |
| MN | MN BCBS | 858K6HA | 01 |
| MN | 318605900 | 05 | |
| ND | 12303 | 05 |
| Street Address |
100 4TH ST S |
| City | FARGO |
| State | ND |
| Zip Code | 58103-1929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720078405 | Mark Allan Schaffer | Dentist | 100 4th St S, Suite 312, Fargo, ND 58103-1929 | 2005-10-25 |
| 1386280261 | Canopy Medical Clinic, Pllc | Nurse Practitioner | 100 4th St S, Fargo, ND 58103-1929 | 2019-11-26 |
| 1437715166 | Diana Rose Slivensky | Psychologist | 100 4th St S, Fargo, ND 58103-1929 | 2019-05-17 |
| 1861945784 | Resolve Behavioral Health, LLC | Community/Behavioral Health | 100 4th St S, Fargo, ND 58103-1929 | 2016-07-27 |
| 1578927315 | Jason Cossette | Pharmacist | 100 4th St S, Fargo, ND 58103-1929 | 2016-04-07 |
| 1437521366 | Nicole A Kiewel | Clinical Neuropsychologist | 100 4th St S, Fargo, ND 58103-1929 | 2015-10-30 |
| 1821472143 | Angela M Lee | Nurse Practitioner | 100 4th St S, Fargo, ND 58103-1929 | 2015-07-16 |
| 1104231992 | Mustafa Abdulhusein | Psychiatry & Neurology | 100 4th St S, Fargo, ND 58103 | 2014-06-30 |
| 1609205988 | Robyn Maley | Psychologist | 100 4th St S, Fargo, ND 58103-1929 | 2013-11-06 |
| 1699102897 | Lindsey Marie Sloan Peterson | Nurse Practitioner | 100 4th St S, Fargo, ND 58103-1929 | 2013-10-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659924843 | Amanda Hericks | Dentist | 1338 Gateway Drive S, Fargo, ND 58103 | 2019-07-17 |
| 1285298240 | Ann Louise Breen | Optometrist | Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 | 2019-04-25 |
| 1245706597 | Lisa Elaine Livingston | Counselor | 1337 14 and Half St. S., Fargo, ND 58103 | 2018-10-15 |
| 1528569662 | Misty Lynn Hagen | Counselor | 901 28th St. South, Suite B, Fargo, ND 58103 | 2018-02-23 |
| 1083133011 | Faith Homecare Professionals LLC | Home Health | 304 25th St S, Suite B, Fargo, ND 58103 | 2017-09-11 |
| 1982138749 | Matthew Troyer | Pharmacist | 2425 13th Ave, Fargo, ND 58103 | 2017-04-18 |
| 1801338504 | Amy Nguyen Christianson | Chiropractor | 1650 45th St S Ste 113, Fargo, ND 58103 | 2016-11-11 |
| 1245772359 | Andrea Marie Hanson | Nurse Practitioner | 2400 32nd Ave South, Fargo, ND 58103 | 2016-11-07 |
| 1831647940 | Abigail Carmen Burkett Vetter | Nurse Practitioner | 2928 University Dr S Suite 101, Fargo, ND 58103 | 2016-09-18 |
| 1013361302 | Nancy Knowlton | Speech-Language Pathologist | 3001 11th Ave S, Beyond Boundaries Speech-language, Fargo, ND 58103 | 2016-04-22 |
| Find all providers in zip 58103 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346479185 | Nivedita Sudhir Nadkarni | Psychiatry & Neurology | 1702 University Drive South, Fargo, ND 58103 | 2009-07-14 |
| 1538218391 | Jane Charlotte Gaffrey | Psychiatry & Neurology | 100 4th St S, Fargo, ND 58103-1929 | 2007-01-10 |
| 1306867528 | Jeanine L Roembach | Psychiatry & Neurology | 100 4th St S, Fargo, ND 58103-1929 | 2006-07-22 |
| 1982622528 | Kenneth J Fischer | Psychiatry & Neurology | 100 4th St S, Fargo, ND 58103-1929 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124064431 | Laura B Schield | Psychiatry & Neurology | 2787 97th Ave Nw, Bismarck, ND 58503-8452 | 2006-06-22 |
| 1376958397 | Kenneth Chidi Asogwa | Psychiatry & Neurology | 860 S Columbia Rd, Grand Forks, ND 58201 | 2014-06-28 |
| 1245541895 | Stephanie Jallen | Psychiatry & Neurology | 900 E Broadway Ave, Bismarck, ND 58501-4520 | 2010-06-29 |
| 1619297785 | Jacqueline M Bell | Psychiatry & Neurology | 1900-8th Ave. S.e., Minot, ND 58701-4935 | 2010-06-10 |
| 1003952144 | Kondal Madaram | Psychiatry & Neurology | 1000 S Columbia Rd, Grand Forks, ND 58201-4032 | 2007-01-29 |
| 1326119884 | Deidre L Richards | Psychiatry & Neurology | 1900 8th Ave Se, Minot, ND 58701-4935 | 2006-11-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.