Healthcare Provider Details

I. General information

NPI: 1871475996
Provider Name (Legal Business Name): JUNELL HANNAH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

267 LANGLEY DR
LAWRENCEVILLE GA
30046-6907
US

IV. Provider business mailing address

267 LANGLEY DR
LAWRENCEVILLE GA
30046-6907
US

V. Phone/Fax

Practice location:
  • Phone: 229-350-7638
  • Fax: 229-321-7503
Mailing address:
  • Phone: 229-350-7638
  • Fax: 229-321-7503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License NumberRN270647
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN270647
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: