Provider Demographics
NPI:1598005753
Name:MYERS, HANNAH L (PA-C)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:L
Last Name:MYERS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4126 N HOLLAND SYLVANIA RD STE 200
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-3537
Mailing Address - Country:US
Mailing Address - Phone:419-473-3257
Mailing Address - Fax:419-517-0230
Practice Address - Street 1:4126 N HOLLAND SYLVANIA RD STE 200
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3537
Practice Address - Country:US
Practice Address - Phone:419-473-3257
Practice Address - Fax:419-473-8816
Is Sole Proprietor?:No
Enumeration Date:2013-02-26
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601006617363A00000X
OH50.005345RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant