Healthcare Provider Details

I. General information

NPI: 1770919516
Provider Name (Legal Business Name): HANNAH LEIGH RICHARDS P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2013
Last Update Date: 12/24/2024
Certification Date: 12/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 MEDICAL PKWY STE 600
ANNAPOLIS MD
21401-3748
US

IV. Provider business mailing address

2000 MEDICAL PKWY STE 600
ANNAPOLIS MD
21401-3748
US

V. Phone/Fax

Practice location:
  • Phone: 443-481-6699
  • Fax:
Mailing address:
  • Phone: 443-481-6699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC0005505
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: