Healthcare Provider Details

I. General information

NPI: 1003742701
Provider Name (Legal Business Name): JESSICA HANNA NRP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 N CAMPBELL AVE
TUCSON AZ
85719-4330
US

IV. Provider business mailing address

4180 E STONE RIVER DR
TUCSON AZ
85712-6651
US

V. Phone/Fax

Practice location:
  • Phone: 907-598-3566
  • Fax:
Mailing address:
  • Phone: 907-598-3566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberP46744475
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: