Healthcare Provider Details

I. General information

NPI: 1043904675
Provider Name (Legal Business Name): HANNAH ELIZABETH GOULD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HANNAH ELIZABETH O'CONNOR

II. Dates (important events)

Enumeration Date: 06/06/2023
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1031 PEMBERTON HILL RD STE 102
APEX NC
27502-4278
US

IV. Provider business mailing address

1358 ROSEPINE DR
CARY NC
27519-6684
US

V. Phone/Fax

Practice location:
  • Phone: 919-372-5489
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: