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General NPI Number Information
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NPI Number | 1730410226
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Entity Type | Individual
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Provider Name | AMY RAQUEAL HANN CRNA
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Gender | Female
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Dates
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Enumeration Date | 01/22/2010
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Last Update Date | 10/05/2016
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Provider Practice Location Address
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Address Line | 150 KINGSLEY LN
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City | NORFOLK
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State | VA
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Zip | 23505-4602
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Country | US
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Telephone | 757-889-5183
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Fax |
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Provider Business Mailing Address
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Address Line | 2301 PAGE HARBOR LNDG APT. 305
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-1059
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Country | US
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Telephone | 318-376-0216
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 0001222245
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License Number State | VA
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