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NPI Code Detail

MEDICARE: THERESE ANNE HANNA FNP

MEDICARE: THERESE ANNE HANNA FNP
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
1363LF0000XFamily Nurse Practitioner775579MS

General Provider Information

NPI Number : 1932545480
Entity Type Code : Individual
Provider Name (Legal Business Name) : THERESE ANNE HANNA FNP
Provider Business Mailing Address
First Line : 5801 SOUTHLAND ST
Second Line :
City : OCEAN SPRINGS
State : MS
Zip : 39564-3609
Country : US
Telephone Number : 228-218-5004
Fax Number : 228-818-9193
Provider Business Practice Location Address
First Line : 6900 WASHINGTON AVENUE
Second Line :
City : OCEAN SPRINGS
State : MS
Zip : 39564
Country : US
Telephone Number : 228-818-9191
Fax Number : 228-818-9193
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2013
Last Update Date : 05/10/2013

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Directions to “ THERESE ANNE HANNA FNP” Practice Location

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