Healthcare Provider Details

I. General information

NPI: 1740038983
Provider Name (Legal Business Name): HANNAH LAUREN SAINE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2024
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MEDLAR FIELD AT LUBRANO PARK 701 PORTER ROAD
UNIVERSITY PARK PA
16802
US

IV. Provider business mailing address

1160 HAWKSBURY DR
CHINA GROVE NC
28023-7303
US

V. Phone/Fax

Practice location:
  • Phone: 704-773-3489
  • Fax:
Mailing address:
  • Phone: 704-773-3489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number2000059363
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: