Healthcare Provider Details

I. General information

NPI: 1669393450
Provider Name (Legal Business Name): HANNAH KATHERINE HENLEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

977 POPLAR CREEK RD
OLIVER SPRINGS TN
37840-2827
US

IV. Provider business mailing address

977 POPLAR CREEK RD
OLIVER SPRINGS TN
37840-2827
US

V. Phone/Fax

Practice location:
  • Phone: 865-399-3703
  • Fax:
Mailing address:
  • Phone: 865-399-3703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number259651
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: