Healthcare Provider Details

I. General information

NPI: 1699538447
Provider Name (Legal Business Name): HANNAH NICOLE BEWLEY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 NEW ALBANY PLZ
NEW ALBANY IN
47150-4658
US

IV. Provider business mailing address

PO BOX 932958
CLEVELAND OH
44193-0028
US

V. Phone/Fax

Practice location:
  • Phone: 812-941-3080
  • Fax:
Mailing address:
  • Phone: 615-425-2000
  • Fax: 615-425-4201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number10004695A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10004695A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: