Healthcare Provider Details

I. General information

NPI: 1144958547
Provider Name (Legal Business Name): HANNAH CISSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2022
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

353 NEW SHACKLE ISLAND RD STE 300C
HENDERSONVILLE TN
37075-2384
US

IV. Provider business mailing address

353 NEW SHACKLE ISLAND RD STE 300C
HENDERSONVILLE TN
37075-2384
US

V. Phone/Fax

Practice location:
  • Phone: 615-824-0043
  • Fax: 615-822-1690
Mailing address:
  • Phone: 615-824-0043
  • Fax: 615-822-1690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number32152
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: