Provider Demographics
NPI:1083024095
Name:SHELL, HANNAH KATHARINE (NP-C)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:KATHARINE
Last Name:SHELL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1267 HIGHWAY 54 W
Mailing Address - Street 2:STE 2200
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-2114
Mailing Address - Country:US
Mailing Address - Phone:770-716-0051
Mailing Address - Fax:770-716-2006
Practice Address - Street 1:1267 HIGHWAY 54 W
Practice Address - Street 2:STE 2200
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-2114
Practice Address - Country:US
Practice Address - Phone:770-716-0051
Practice Address - Fax:770-716-2006
Is Sole Proprietor?:No
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN203906363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily