Provider Demographics
NPI:1225155567
Name:WHIPPLE, HANNAH LASELL (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:LASELL
Last Name:WHIPPLE
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 WEBER ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:LA
Mailing Address - Zip Code:70538-4124
Mailing Address - Country:US
Mailing Address - Phone:337-828-2550
Mailing Address - Fax:337-355-2335
Practice Address - Street 1:809 W TUNNEL BLVD
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-5555
Practice Address - Country:US
Practice Address - Phone:985-851-1717
Practice Address - Fax:337-355-2335
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN 116911163W00000X
TNRN 152036163W00000X
LAAPRN 05099363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
72-6073441OtherFEDERAL TAX ID