Healthcare Provider Details

I. General information

NPI: 1215675160
Provider Name (Legal Business Name): HANNAH BRITTAINY SHOUPE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNAH BRITTAINY HIGDON PA-C

II. Dates (important events)

Enumeration Date: 05/20/2022
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2165 MEDICAL PARK DR
HICKORY NC
28602-8809
US

IV. Provider business mailing address

PO BOX 5105
BELFAST ME
04915-5100
US

V. Phone/Fax

Practice location:
  • Phone: 828-459-6824
  • Fax: 828-294-9141
Mailing address:
  • Phone: 828-459-6824
  • Fax: 828-294-9141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-12315
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2024041967
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: