Provider Demographics
NPI:1447744354
Name:CROFFIE, HANNAH ZIKER (NP-C)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:ZIKER
Last Name:CROFFIE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:ROSE
Other - Last Name:ZIKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2605 N LEBANON ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:IN
Mailing Address - Zip Code:46052-1476
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 N MOUNT ZION RD
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:IN
Practice Address - Zip Code:46052-9497
Practice Address - Country:US
Practice Address - Phone:765-335-0123
Practice Address - Fax:765-335-0127
Is Sole Proprietor?:No
Enumeration Date:2018-06-15
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28193030A363LF0000X
IN71008660A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300025843Medicaid