Healthcare Provider Details

I. General information

NPI: 1356229975
Provider Name (Legal Business Name): HANNA LUCILLE CUMMINS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2025
Last Update Date: 08/22/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1122 12TH ST
HAWARDEN IA
51023-1900
US

IV. Provider business mailing address

1111 11TH ST
HAWARDEN IA
51023-1903
US

V. Phone/Fax

Practice location:
  • Phone: 712-551-3400
  • Fax:
Mailing address:
  • Phone: 712-551-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: