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General NPI Number Information
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NPI Number | 1518426337
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Entity Type | Individual
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Provider Name | MARIE MICHELLE HANNA
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Gender | Female
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Dates
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Enumeration Date | 03/19/2019
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Last Update Date | 07/13/2023
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Provider Practice Location Address
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Address Line | 10103 RIDGEGATE PKWY STE 200
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City | LONE TREE
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State | CO
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Zip | 80124-5525
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Country | US
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Telephone | 303-788-6657
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Fax |
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Provider Business Mailing Address
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Address Line | 10103 RIDGEGATE PKWY STE 200
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City | LONE TREE
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State | CO
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Zip | 80124-5525
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Country | US
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Telephone | 303-788-6657
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | DR.0070485
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | DR.0070485
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License Number State | CO
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