Provider Demographics
NPI:1770832776
Name:AGARD, HANNA REBECCA (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:HANNA
Middle Name:REBECCA
Last Name:AGARD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:HANNA
Other - Middle Name:REBECCA
Other - Last Name:KILGORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:623 MAITLAND AVE STE 2200
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-6823
Mailing Address - Country:US
Mailing Address - Phone:407-830-8661
Mailing Address - Fax:407-830-0280
Practice Address - Street 1:623 MAITLAND AVE STE 2200
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701
Practice Address - Country:US
Practice Address - Phone:407-830-8661
Practice Address - Fax:407-830-0280
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9253191363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health