Healthcare Provider Details

I. General information

NPI: 1689540296
Provider Name (Legal Business Name): HANNAH ALICE MAX-DEAH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 E FORT LOWELL RD STE 100
TUCSON AZ
85719-2384
US

IV. Provider business mailing address

102 WOODMONT BLVD STE 600
NASHVILLE TN
37205-5250
US

V. Phone/Fax

Practice location:
  • Phone: 520-613-0001
  • Fax: 520-504-6482
Mailing address:
  • Phone: 888-987-1151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number231349
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: