Provider Demographics
NPI:1821205311
Name:HAHN, TERRI L (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:L
Last Name:HAHN
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5757 W THUNDERBIRD RD
Mailing Address - Street 2:SUITE E157
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-4641
Mailing Address - Country:US
Mailing Address - Phone:602-393-2450
Mailing Address - Fax:602-393-2458
Practice Address - Street 1:5757 W THUNDERBIRD RD
Practice Address - Street 2:SUITE E157
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4641
Practice Address - Country:US
Practice Address - Phone:602-393-2450
Practice Address - Fax:602-393-2458
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZRN051682207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ480963OtherAHCCCS