Provider Demographics
NPI:1760651095
Name:HAHN, BETTY JANE
Entity Type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:JANE
Last Name:HAHN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3650 PENDLEBURY DR
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-2667
Mailing Address - Country:US
Mailing Address - Phone:727-943-8733
Mailing Address - Fax:
Practice Address - Street 1:3650 PENDLEBURY DR
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34685-2667
Practice Address - Country:US
Practice Address - Phone:727-943-8733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL160664376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide