MEDICARE: HANNAH PENDLEY

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1730652454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH PENDLEY

Provider Business Mailing Address
First Line	:	7110 SKYE BRIDGE WAY APT 202
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28278-6790
Country	:	US
Telephone Number	:	828-291-3047
Fax Number	:

Provider Business Practice Location Address
First Line	:	7110 SKYE BRIDGE WAY APT 202
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28278-6790
Country	:	US
Telephone Number	:	828-291-3047
Fax Number	:

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

Provider Enumeration Date	:	01/04/2019
Last Update Date	:	03/20/2019

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Directions to “ HANNAH PENDLEY ” Practice Location

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