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General NPI Number Information
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NPI Number | 1548564347
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Entity Type | Individual
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Provider Name | MARY ELIZABETH HANNON RN
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Gender | Female
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Dates
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Enumeration Date | 01/07/2011
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 5819 W 8 MILE RD
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City | CALEDONIA
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State | WI
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Zip | 53108-9735
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Country | US
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Telephone | 414-243-3663
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Fax |
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Provider Business Mailing Address
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Address Line | 5819 W 8 MILE RD
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City | CALEDONIA
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State | WI
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Zip | 53108-9735
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Country | US
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Telephone | 414-243-3663
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 115333-30
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License Number State | WI
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