Provider Demographics
NPI:1417594086
Name:BARBARA HANNAH
Entity Type:Organization
Organization Name:BARBARA HANNAH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:S
Authorized Official - Last Name:HANNAH
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:765-620-3536
Mailing Address - Street 1:11800 N 300 W
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:IN
Mailing Address - Zip Code:46001-8689
Mailing Address - Country:US
Mailing Address - Phone:765-620-3536
Mailing Address - Fax:
Practice Address - Street 1:11800 N 300 W
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:IN
Practice Address - Zip Code:46001-8689
Practice Address - Country:US
Practice Address - Phone:765-620-3536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-03
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service