Healthcare Provider Details

I. General information

NPI: 1184509911
Provider Name (Legal Business Name): HANNAH LEE WHEELER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNAH LEE WILMOT

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 YORKTOWN DR
FAYETTEVILLE GA
30214-1578
US

IV. Provider business mailing address

13 STRATFORD HALL PL NE
ATLANTA GA
30342-3749
US

V. Phone/Fax

Practice location:
  • Phone: 770-460-4285
  • Fax:
Mailing address:
  • Phone: 404-984-7151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: