Healthcare Provider Details

I. General information

NPI: 1437578739
Provider Name (Legal Business Name): HANNAH DENTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 04/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N ROCKINGCHAIR RD STE 2
PARAGOULD AR
72450-2475
US

IV. Provider business mailing address

57 COUNTY ROAD 7804
JONESBORO AR
72401-9259
US

V. Phone/Fax

Practice location:
  • Phone: 870-335-9617
  • Fax:
Mailing address:
  • Phone: 931-349-4213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: