Healthcare Provider Details

I. General information

NPI: 1528686326
Provider Name (Legal Business Name): HANNAH E WASSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2020
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

174 PEDRO WAY
WINCHESTER KY
40391-8354
US

IV. Provider business mailing address

174 PEDRO WAY
WINCHESTER KY
40391-8354
US

V. Phone/Fax

Practice location:
  • Phone: 859-274-7713
  • Fax: 859-545-4912
Mailing address:
  • Phone: 859-274-7713
  • Fax: 859-545-4912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3014755
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3014755
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: