Provider Demographics
NPI:1760748503
Name:HANNA, MARIE JORDAN (BSN, MSN, CRNP)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:JORDAN
Last Name:HANNA
Suffix:
Gender:F
Credentials:BSN, MSN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2008
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35011-2008
Mailing Address - Country:US
Mailing Address - Phone:256-234-4443
Mailing Address - Fax:256-234-3686
Practice Address - Street 1:44 ALIANT PKWY
Practice Address - Street 2:
Practice Address - City:ALEXANDER CITY
Practice Address - State:AL
Practice Address - Zip Code:35010-3466
Practice Address - Country:US
Practice Address - Phone:256-234-4443
Practice Address - Fax:256-234-3686
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-05
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-111571363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics