MEDICARE: DR. KEVIN PATRICK HANAWAY DNP, MBA, 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	363LG0600X	Gerontology Nurse Practitioner	APRN3361362	FL
2	363LP2300X	Primary Care Nurse Practitioner	APRN3361362	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447666086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN PATRICK HANAWAY DNP, MBA, APRN

Provider Business Mailing Address
First Line	:	3233 NE 34TH ST APT 1006
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-6946
Country	:	US
Telephone Number	:	954-383-6389
Fax Number	:

Provider Business Practice Location Address
First Line	:	3233 NE 34TH ST APT 1006
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-6946
Country	:	US
Telephone Number	:	954-383-6389
Fax Number	:	559-238-0489

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

Provider Enumeration Date	:	07/03/2014
Last Update Date	:	07/24/2025

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