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General NPI Number Information
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NPI Number | 1720617962
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Entity Type | Individual
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Provider Name | NICHOLAS MICHAEL HANNA MD
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Gender | Male
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Dates
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Enumeration Date | 04/08/2020
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 2800 CLAY EDWARDS DR
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City | KANSAS CITY
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State | MO
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Zip | 64116-3220
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Country | US
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Telephone | 816-691-5201
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Fax |
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Provider Business Mailing Address
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Address Line | 2800 CLAY EDWARDS DR
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City | KANSAS CITY
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State | MO
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Zip | 64116-3220
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Country | US
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Telephone | 913-642-4900
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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 | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | 2021023178
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 2021023178
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 04-50806
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License Number State | KS
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Taxonomy #4
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | 94-10694
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License Number State | KS
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