Provider Demographics
NPI:1467153775
Name:HANNAH, NATASHA SHAWNTA
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:SHAWNTA
Last Name:HANNAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 MILL CREEK PKWY
Mailing Address - Street 2:302
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-1098
Mailing Address - Country:US
Mailing Address - Phone:757-614-9898
Mailing Address - Fax:
Practice Address - Street 1:111 MILL CREEK PKWY # 302
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23323-1098
Practice Address - Country:US
Practice Address - Phone:757-614-9898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program