MEDICARE: HANNAH HEAD APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	4007499	KY

General Provider Information

NPI Number	:	1134800816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH HEAD APRN

Provider Business Mailing Address
First Line	:	200 ABRAHAM FLEXNER WAY STE 1200
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-2877
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 776351
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-1886
Country	:	US
Telephone Number	:	502-587-4011
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2023
Last Update Date	:	06/13/2025

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Directions to “ HANNAH HEAD APRN” Practice Location

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