Provider Demographics
NPI:1346206273
Name:HANNUM, CURTISS P (CRNP)
Entity Type:Individual
Prefix:MS
First Name:CURTISS
Middle Name:P
Last Name:HANNUM
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 KINGS HWY N
Mailing Address - Street 2:CHERRY HILL WOMEN'S CENTER
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1502
Mailing Address - Country:US
Mailing Address - Phone:856-667-5910
Mailing Address - Fax:
Practice Address - Street 1:502 KINGS HWY N
Practice Address - Street 2:CHERRY HILL WOMEN'S CENTER
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1502
Practice Address - Country:US
Practice Address - Phone:856-667-5910
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00044000363LW0102X
NJ26NR10833400163WW0101X
PARN535435163WW0101X
PASP007687363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Not Answered163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0072133Medicaid