Healthcare Provider Details

I. General information

NPI: 1063575355
Provider Name (Legal Business Name): KATHRYN HEIDI HANNA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHRYN HEIDI SCIARRETTA M.D.

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 SEWALL ST
PORTLAND ME
04102-2603
US

IV. Provider business mailing address

33 SEWALL ST
PORTLAND ME
04102-2603
US

V. Phone/Fax

Practice location:
  • Phone: 207-828-2100
  • Fax:
Mailing address:
  • Phone: 207-828-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberMD20772
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: