Provider Demographics
NPI:1083080295
Name:MANSON, HANNAH L (PA)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:L
Last Name:MANSON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:L
Other - Last Name:BAER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:100 SENTARA CIR RM 2C
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-5713
Mailing Address - Country:US
Mailing Address - Phone:757-984-7217
Mailing Address - Fax:757-984-7210
Practice Address - Street 1:100 SENTARA CIR RM 2C
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-5713
Practice Address - Country:US
Practice Address - Phone:757-984-7217
Practice Address - Fax:757-984-7210
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2537363A00000X
VA0110007149363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant