Provider Demographics
NPI:1063454825
Name:HANNA, DAWN MARIE (PA)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:HANNA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 487
Mailing Address - Street 2:
Mailing Address - City:SAINT FRANCISVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70775-0487
Mailing Address - Country:US
Mailing Address - Phone:225-635-5848
Mailing Address - Fax:225-635-5847
Practice Address - Street 1:5326 OAK ST
Practice Address - Street 2:
Practice Address - City:SAINT FRANCISVILLE
Practice Address - State:LA
Practice Address - Zip Code:70775-4510
Practice Address - Country:US
Practice Address - Phone:225-635-5848
Practice Address - Fax:225-635-5847
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA300747363AM0700X
TXPA04599363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant