Healthcare Provider Details

I. General information

NPI: 1598417974
Provider Name (Legal Business Name): HANNAH WHITWORTH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2022
Last Update Date: 01/27/2024
Certification Date: 01/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 BABB DR
LEBANON TN
37087-2506
US

IV. Provider business mailing address

913 PECONIC PL
MURFREESBORO TN
37130-9511
US

V. Phone/Fax

Practice location:
  • Phone: 615-758-4888
  • Fax:
Mailing address:
  • Phone: 615-542-0840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number182445
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1824445
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number6923
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: