Healthcare Provider Details

I. General information

NPI: 1174709364
Provider Name (Legal Business Name): HANNAH M WIMSATT ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNAH M WILLIAMS

II. Dates (important events)

Enumeration Date: 01/17/2008
Last Update Date: 02/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 OLD MAIN ST DOCTORS BUILDING
HARTFORD KY
42347-1619
US

IV. Provider business mailing address

1215 OLD MAIN ST DOCTORS BUILDING
HARTFORD KY
42347-1619
US

V. Phone/Fax

Practice location:
  • Phone: 270-298-5404
  • Fax: 270-295-5285
Mailing address:
  • Phone: 270-298-5404
  • Fax: 270-295-5285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5054P
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: