Healthcare Provider Details

I. General information

NPI: 1811824477
Provider Name (Legal Business Name): HANNAH MAGNOLIA CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19450 DEERFIELD AVE STE 460
LEESBURG VA
20176-6840
US

IV. Provider business mailing address

5801 POSTAL RD UNIT 81310
CLEVELAND OH
44181-2112
US

V. Phone/Fax

Practice location:
  • Phone: 571-707-8522
  • Fax: 571-707-8577
Mailing address:
  • Phone: 301-340-8339
  • Fax: 301-340-9027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number0024197358
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: