Healthcare Provider Details

I. General information

NPI: 1013791110
Provider Name (Legal Business Name): HANNAH GRACE MCDONALD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2023
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

731 E MAIN ST STE 4
JACKSON OH
45640-2100
US

IV. Provider business mailing address

4 HILLTOP DR
JACKSON OH
45640-1938
US

V. Phone/Fax

Practice location:
  • Phone: 740-577-3527
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0034681
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: