MEDICARE: HANNAH CLIFF PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	4171350	ID

General Provider Information

NPI Number	:	1336952662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH CLIFF PA-C

Provider Business Mailing Address
First Line	:	PO BOX 742941
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-2941
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1906 FAIRVIEW AVE STE 230
Second Line	:
City	:	CALDWELL
State	:	ID
Zip	:	83605-5432
Country	:	US
Telephone Number	:	208-795-5073
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2025
Last Update Date	:	04/15/2026

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Directions to “ HANNAH CLIFF PA-C” Practice Location

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