Provider Demographics
NPI:1679008981
Name:SELLERS, HANNAH RAE (RN, FNP-C)
Entity Type:Individual
Prefix:MS
First Name:HANNAH
Middle Name:RAE
Last Name:SELLERS
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2133 E 2ND ST
Mailing Address - Street 2:APT 10103
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-6362
Mailing Address - Country:US
Mailing Address - Phone:405-326-0718
Mailing Address - Fax:
Practice Address - Street 1:2133 E 2ND ST
Practice Address - Street 2:APT 10103
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-6362
Practice Address - Country:US
Practice Address - Phone:405-326-0718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK107503163W00000X, 363LF0000X
TX834706163W00000X
TXAP133432363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse