MEDICARE: HEATHER B HANNAN 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	207QA0505X	Adult Medicine Physician	071826-23	NH
2	363LF0000X	Family Nurse Practitioner	071826-23	NH

General Provider Information

NPI Number	:	1578139507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER B HANNAN APRN

Provider Business Mailing Address
First Line	:	250 PLEASANT ST
Second Line	:
City	:	CONCORD
State	:	NH
Zip	:	03301-2598
Country	:	US
Telephone Number	:	603-227-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	590 COURT ST
Second Line	:
City	:	KEENE
State	:	NH
Zip	:	03431-1719
Country	:	US
Telephone Number	:	603-354-5400
Fax Number	:

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

Provider Enumeration Date	:	06/01/2021
Last Update Date	:	05/19/2026

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