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General NPI Number Information
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NPI Number | 1588649248
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Entity Type | Individual
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Provider Name | NICOLE HANNA NP
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Gender | Female
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Dates
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Enumeration Date | 12/14/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 28248 N TATUM BLVD BUILDING B1 SUITE 605
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City | CAVE CREEK
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State | AZ
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Zip | 85331-6343
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Country | US
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Telephone | 602-996-5595
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Fax | 602-996-5607
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Provider Business Mailing Address
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Address Line | 28248 N TATUM BLVD BUILDING B1 SUITE 605
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City | CAVE CREEK
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State | AZ
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Zip | 85331-6343
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Country | US
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Telephone | 602-996-5595
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Fax | 602-996-5607
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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 | RN099001
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License Number State | AZ
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