Healthcare Provider Details

I. General information

NPI: 1629733167
Provider Name (Legal Business Name): HANNA NEAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2021
Last Update Date: 07/23/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 RITCHIE HWY STE 103
ARNOLD MD
21012-2704
US

IV. Provider business mailing address

1211 S EATON ST UNIT 7012
BALTIMORE MD
21224-4384
US

V. Phone/Fax

Practice location:
  • Phone: 443-949-8373
  • Fax:
Mailing address:
  • Phone: 985-768-1795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number45579
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number29478
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: