Provider Demographics
NPI:1699177709
Name:HANNA, ASHLEY (CRNP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:HANNA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:COSTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3764 CROSSHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2833
Mailing Address - Country:US
Mailing Address - Phone:850-687-3822
Mailing Address - Fax:
Practice Address - Street 1:1940 ELMER J BISSELL RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-2941
Practice Address - Country:US
Practice Address - Phone:205-638-4823
Practice Address - Fax:205-638-4994
Is Sole Proprietor?:No
Enumeration Date:2014-09-19
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-131612363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics