Provider Demographics
NPI:1194603373
Name:EIDE, HANNA (CNP)
Entity type:Individual
Prefix:
First Name:HANNA
Middle Name:
Last Name:EIDE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:HANNA
Other - Middle Name:
Other - Last Name:SLAGLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 765
Mailing Address - Street 2:
Mailing Address - City:CLEAR LAKE
Mailing Address - State:SD
Mailing Address - Zip Code:57226-0765
Mailing Address - Country:US
Mailing Address - Phone:605-370-2790
Mailing Address - Fax:
Practice Address - Street 1:901 4TH ST NW
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:SD
Practice Address - Zip Code:57201-1558
Practice Address - Country:US
Practice Address - Phone:605-886-8471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP003773363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily