MEDICARE: MRS. HANNAH LOGIE SOMENSATTO ARNP

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	363LF0000X	Family Nurse Practitioner	ARNP 9244082	FL

General Provider Information

NPI Number	:	1750514055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HANNAH LOGIE SOMENSATTO ARNP

Provider Business Mailing Address
First Line	:	157 CROSSROAD LAKES DR
Second Line	:
City	:	PONTE VEDRA BEACH
State	:	FL
Zip	:	32082-4034
Country	:	US
Telephone Number	:	904-254-6589
Fax Number	:

Provider Business Practice Location Address
First Line	:	103B SOLANA RD
Second Line	:
City	:	PONTE VEDRA BEACH
State	:	FL
Zip	:	32082-2231
Country	:	US
Telephone Number	:	904-273-2717
Fax Number	:	904-273-0410

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

Provider Enumeration Date	:	09/02/2009
Last Update Date	:	10/01/2012

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