Healthcare Provider Details

I. General information

NPI: 1992426795
Provider Name (Legal Business Name): HANNAH LYNN CAVENDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2022
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3210 N CROATAN HWY # 1B
KILL DEVIL HILLS NC
27948-8515
US

IV. Provider business mailing address

PO BOX 184
KITTY HAWK NC
27949-0184
US

V. Phone/Fax

Practice location:
  • Phone: 704-654-8599
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number30003496
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: