Provider Demographics
NPI:1578142840
Name:HANNA, RAND (MD)
Entity Type:Individual
Prefix:
First Name:RAND
Middle Name:
Last Name:HANNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 N 12TH ST STE 320
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2858
Mailing Address - Country:US
Mailing Address - Phone:602-521-3046
Mailing Address - Fax:602-521-3046
Practice Address - Street 1:1300 N 12TH ST STE 320
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2858
Practice Address - Country:US
Practice Address - Phone:602-521-3050
Practice Address - Fax:602-521-3046
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-05
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ689822084P0800X
AZ390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty