Healthcare Provider Details

I. General information

NPI: 1124614045
Provider Name (Legal Business Name): HANNAH LUCILLE MEYERHOFFER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2020
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 E 4TH ST
LIMA OH
45804-4172
US

IV. Provider business mailing address

14151 ROAD K14
OTTAWA OH
45875-9448
US

V. Phone/Fax

Practice location:
  • Phone: 937-557-5657
  • Fax: 513-230-2024
Mailing address:
  • Phone: 419-305-1819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.007473RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: