Healthcare Provider Details

I. General information

NPI: 1346878600
Provider Name (Legal Business Name): HANNAH LEIGH WARE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNAH HICKS

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 06/25/2020
Certification Date: 06/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 MALVERN AVE
HOT SPRINGS AR
71901-7752
US

IV. Provider business mailing address

PO BOX 22390
HOT SPRINGS AR
71903-2390
US

V. Phone/Fax

Practice location:
  • Phone: 13-211-0005
  • Fax: 501-620-2336
Mailing address:
  • Phone: 855-592-5265
  • Fax: 855-759-1165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR101327
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number124571
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: