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General NPI Number Information
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NPI Number | 1578715421
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Entity Type | Individual
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Provider Name | JENNIFER LYNN HANLON PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/22/2008
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Last Update Date | 12/06/2021
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Provider Practice Location Address
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Address Line | 141 PIEDMONT AVE NE STE D
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City | ATLANTA
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State | GA
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Zip | 30303-2417
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Country | US
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Telephone | 404-413-1944
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Fax | 404-413-1953
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Provider Business Mailing Address
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Address Line | 141 PIEDMONT AVE NE STE D
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City | ATLANTA
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State | GA
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Zip | 30303-2417
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Country | US
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Telephone | 404-413-1944
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Fax | 404-413-1953
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2274
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 20465
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 7589
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License Number State | GA
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