Hanna Blanche Kristin Matoy Banta

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Newark, DE

NPI 1801734173 · NPPES record last updated Mar 24, 2026

Key facts

NPI
1801734173
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
4755 Ogletown Stanton Rd
Newark, DE 19718-0002
Phone
(415) 860-4367
NPI assigned
Mar 24, 2026
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20260507001989 DE Order and Referring Only - Emergency Medicine
Practitioner - Emergency Medicine
3779051727

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

4755 Ogletown Stanton Rd
Newark, DE 19718-0002

Mailing address

4755 Ogletown Stanton Rd
Newark, DE 19718-0002
Phone (302) 733-1000

Other providers in Newark, DE

All providers in Newark, DE · Student in an Organized Health Care Education/Training Program in Delaware

Sources for this page

Verify at the official NPI Registry.