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General NPI Number Information
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NPI Number | 1265404644
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Entity Type | Individual
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Provider Name | WENDY JO HANNON APRN,PMHNP-BC,ANP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/01/2006
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Last Update Date | 07/12/2024
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Provider Practice Location Address
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Address Line | 8009 CORPORATE DR UNIT C
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City | NOTTINGHAM
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State | MD
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Zip | 21236-4977
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Country | US
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Telephone | 410-838-9500
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Fax |
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Provider Business Mailing Address
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Address Line | 841 E FORT AVE # 366
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City | BALTIMORE
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State | MD
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Zip | 21230-5117
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | R133863
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | R133863
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R133863
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License Number State | MD
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