Provider Demographics
NPI:1306861406
Name:HANNA, LUCRETIA (CERTIF NURSE MIDWIFE)
Entity Type:Individual
Prefix:
First Name:LUCRETIA
Middle Name:
Last Name:HANNA
Suffix:
Gender:F
Credentials:CERTIF NURSE MIDWIFE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MORSE LOOP
Mailing Address - Street 2:
Mailing Address - City:WARNER
Mailing Address - State:NH
Mailing Address - Zip Code:03278-4106
Mailing Address - Country:US
Mailing Address - Phone:603-456-2229
Mailing Address - Fax:
Practice Address - Street 1:14 MORSE LOOP
Practice Address - Street 2:
Practice Address - City:WARNER
Practice Address - State:NH
Practice Address - Zip Code:03278-4106
Practice Address - Country:US
Practice Address - Phone:603-456-2229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH030308-23-01367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30003308Medicaid
NH30003308Medicare ID - Type UnspecifiedCERTIFIED NURSE MIDWIFE
NH30003308Medicaid
MEQ60047Medicare UPIN