MEDICARE: CHARLENE DENISE HANNA APRN-CNM

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	363L00000X	Nurse Practitioner	APN001092	NV
2	367A00000X	Advanced Practice Midwife	APN001092	NV

General Provider Information

NPI Number	:	1477708659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLENE DENISE HANNA APRN-CNM

Provider Business Mailing Address
First Line	:	8906 SPANISH RIDGE AVE STE 202
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-1319
Country	:	US
Telephone Number	:	702-330-3102
Fax Number	:	702-912-4994

Provider Business Practice Location Address
First Line	:	3930 W ANN RD STE 100
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-3842
Country	:	US
Telephone Number	:	702-438-4692
Fax Number	:	702-485-2372

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

Provider Enumeration Date	:	12/01/2008
Last Update Date	:	05/24/2023

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