Healthcare Provider Details

I. General information

NPI: 1437621679
Provider Name (Legal Business Name): HANNAH ALDRIDGE PA-C, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2018
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 ARRINGDON PARK DR
MORRISVILLE NC
27560-5676
US

IV. Provider business mailing address

5601 ARRINGDON PARK DR
MORRISVILLE NC
27560-5676
US

V. Phone/Fax

Practice location:
  • Phone: 919-660-5430
  • Fax: 919-668-6475
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-12679
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: