Provider Demographics
NPI:1164808028
Name:HANNA, CHRISTINA GRACE (DNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:GRACE
Last Name:HANNA
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:CHRISTI
Other - Middle Name:
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP-C
Mailing Address - Street 1:PO BOX 1000
Mailing Address - Street 2:DEPT #457
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38148-0457
Mailing Address - Country:US
Mailing Address - Phone:901-516-0929
Mailing Address - Fax:
Practice Address - Street 1:1265 UNION AVE
Practice Address - Street 2:SUITE 184
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3415
Practice Address - Country:US
Practice Address - Phone:901-516-9183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20175363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily