Healthcare Provider Details

I. General information

NPI: 1144692328
Provider Name (Legal Business Name): HANNAH HERTEL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2015
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5651 FRIST BLVD STE 200
HERMITAGE TN
37076-2056
US

IV. Provider business mailing address

5651 FRIST BLVD STE 200
HERMITAGE TN
37076-2056
US

V. Phone/Fax

Practice location:
  • Phone: 615-885-0200
  • Fax: 615-885-0267
Mailing address:
  • Phone: 615-885-0200
  • Fax: 615-885-0267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number4599
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License Number4599
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number4599
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number4599
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: