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General NPI Number Information
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NPI Number | 1932545480
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Entity Type | Individual
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Provider Name | THERESE ANNE HANNA FNP
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Gender | Female
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Dates
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Enumeration Date | 05/10/2013
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Last Update Date | 05/10/2013
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Provider Practice Location Address
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Address Line | 6900 WASHINGTON AVENUE
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564
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Country | US
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Telephone | 228-818-9191
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Fax | 228-818-9193
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Provider Business Mailing Address
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Address Line | 5801 SOUTHLAND ST
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-3609
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Country | US
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Telephone | 228-218-5004
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Fax | 228-818-9193
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 775579
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License Number State | MS
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