Healthcare Provider Details

I. General information

NPI: 1093036071
Provider Name (Legal Business Name): HANNAH JOANN SANDERS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNAH FELLERS BENELLI

II. Dates (important events)

Enumeration Date: 06/14/2010
Last Update Date: 12/13/2022
Certification Date: 12/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 CHASE PO BOX 160
CORDOVA AK
99574-0160
US

IV. Provider business mailing address

PO BOX 160
CORDOVA AK
99574-0160
US

V. Phone/Fax

Practice location:
  • Phone: 907-424-8200
  • Fax:
Mailing address:
  • Phone: 907-424-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMD2012-0722
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD60820844
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberCS00218341
License Number StateNM

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: