Healthcare Provider Details

I. General information

NPI: 1700193364
Provider Name (Legal Business Name): DAWN MARIE HANNAH D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2010
Last Update Date: 09/01/2020
Certification Date: 09/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8333 N DAVIS HWY FL 7
PENSACOLA FL
32514-6050
US

IV. Provider business mailing address

8333 N DAVIS HWY FL 7
PENSACOLA FL
32514-6050
US

V. Phone/Fax

Practice location:
  • Phone: 850-969-2038
  • Fax: 850-969-2037
Mailing address:
  • Phone: 850-969-2038
  • Fax: 850-969-2037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number077943
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberOS017083
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberOS11822
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: