Basic Information
| Provider Information | |||||||||
| NPI: | 1831551084 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HACKENMILLER | ||||||||
| FirstName: | ANNA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8701 WATERTOWN PLANK ROAD | ||||||||
| Address2: | MCW DEPT. OF PSYCH. | ||||||||
| City: | MILWAUKEE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 53226 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4149558998 | ||||||||
| FaxNumber: | 4149556299 | ||||||||
| Practice Location | |||||||||
| Address1: | 1657 S NETTLETON LN | ||||||||
| Address2: | |||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992246108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2064994650 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2016 | ||||||||
| LastUpdateDate: | 08/18/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 6772620 | WI | N | Allopathic & Osteopathic Physicians | General Practice | 208D00000X | 61013270 | WA | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.