Provider Demographics
NPI:1154659043
Name:ATKINS, HANNAH S (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:HANNAH
Middle Name:S
Last Name:ATKINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 SOUTHPOINT DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-6350
Mailing Address - Country:US
Mailing Address - Phone:859-272-1928
Mailing Address - Fax:859-271-9601
Practice Address - Street 1:630 SOUTHPOINT DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40515-6350
Practice Address - Country:US
Practice Address - Phone:859-272-1928
Practice Address - Fax:859-271-9601
Is Sole Proprietor?:No
Enumeration Date:2009-12-03
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTC013363A00000X
KYPA1621363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY95900478OtherLC MEDICAID GROUP ID
KY0169OtherLC MEDICARE GROUP ID
KY7100169800Medicaid
KY95900478OtherLC MEDICAID GROUP ID