Provider Demographics
NPI:1306195706
Name:MEADE, HANNAH BREARLEY (FNP)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:BREARLEY
Last Name:MEADE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:LOUISE
Other - Last Name:BREARLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1 INDEPENDENCE PT
Mailing Address - Street 2:SUITE 212
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4545
Mailing Address - Country:US
Mailing Address - Phone:864-797-6044
Mailing Address - Fax:
Practice Address - Street 1:105 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-5608
Practice Address - Country:US
Practice Address - Phone:864-797-7060
Practice Address - Fax:864-797-7077
Is Sole Proprietor?:No
Enumeration Date:2012-08-31
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17999363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP2140Medicaid
SCNP2140Medicaid