Healthcare Provider Details

I. General information

NPI: 1205209194
Provider Name (Legal Business Name): EMILY ANN HANNA NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY LYLE

II. Dates (important events)

Enumeration Date: 11/02/2015
Last Update Date: 10/05/2020
Certification Date: 10/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5080 DELHI RD
CINCINNATI OH
45238-5343
US

IV. Provider business mailing address

2620 ELM HILL PIKE
NASHVILLE TN
37214-3108
US

V. Phone/Fax

Practice location:
  • Phone: 523-347-1925
  • Fax: 513-347-1926
Mailing address:
  • Phone: 615-425-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1146506
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number345164
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3009889
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number17422
License Number StateOH
# 5
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.17422-NP
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: