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NPI Code Detail

MEDICARE: HANNAH LYNN NICELY

MEDICARE: HANNAH LYNN NICELY
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
1225100000XPhysical Therapist10821RLA

General Provider Information

NPI Number : 1487461893
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH LYNN NICELY
Provider Business Mailing Address
First Line : 3223 46TH ST
Second Line :
City : METAIRIE
State : LA
Zip : 70001-4111
Country : US
Telephone Number : 772-418-2746
Fax Number :
Provider Business Practice Location Address
First Line : 1705 TARBORO ST SW
Second Line :
City : WILSON
State : NC
Zip : 27893-3437
Country : US
Telephone Number : 252-399-8040
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2024
Last Update Date : 12/18/2024

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Directions to “ HANNAH LYNN NICELY ” Practice Location

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