Provider Demographics
NPI:1376873224
Name:TUALLA, HANNAH T (NP, MSN, OCN)
Entity Type:Individual
Prefix:MISS
First Name:HANNAH
Middle Name:T
Last Name:TUALLA
Suffix:
Gender:F
Credentials:NP, MSN, OCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 BEVERLY BLVD. AC# 1043-4
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048
Mailing Address - Country:US
Mailing Address - Phone:310-423-5054
Mailing Address - Fax:310-659-3928
Practice Address - Street 1:8700 BEVERLY BLVD. AC# 1043-4
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048
Practice Address - Country:US
Practice Address - Phone:310-423-5054
Practice Address - Fax:310-659-3928
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-28
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA645442363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health