Healthcare Provider Details

I. General information

NPI: 1851007496
Provider Name (Legal Business Name): HANNAH HOJEIJ NICLOU NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HANNAH HOJEIJ NP

II. Dates (important events)

Enumeration Date: 01/26/2023
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1267 HIGHWAY 54 W STE 4100
FAYETTEVILLE GA
30214-2112
US

IV. Provider business mailing address

745 POPLAR RD
NEWNAN GA
30265-1618
US

V. Phone/Fax

Practice location:
  • Phone: 770-506-5470
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN299548
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: