Provider Demographics
NPI:1497407290
Name:HANNAH, CHRISTY (LPN)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:HANNAH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 TATE RD
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38571-1211
Mailing Address - Country:US
Mailing Address - Phone:865-282-6929
Mailing Address - Fax:
Practice Address - Street 1:414 TATE RD
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38571-1211
Practice Address - Country:US
Practice Address - Phone:865-282-6929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-22
Last Update Date:2022-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN78113164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse