Provider Demographics
NPI:1265040745
Name:CRETA, HANNAH (PMHNP)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:CRETA
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1395 ATWOOD AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919-4930
Mailing Address - Country:US
Mailing Address - Phone:401-241-3344
Mailing Address - Fax:401-563-8656
Practice Address - Street 1:1395 ATWOOD AVE STE 106
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919-4930
Practice Address - Country:US
Practice Address - Phone:401-241-3344
Practice Address - Fax:401-563-8656
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-21
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN2319632163W00000X
RIAPRN02546363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty