Provider Demographics
NPI:1922619535
Name:ATKINS, HANNAH BETHANY (PA-C)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:BETHANY
Last Name:ATKINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 DEFENSE HWY STE 205
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7096
Mailing Address - Country:US
Mailing Address - Phone:855-527-7246
Mailing Address - Fax:502-272-5338
Practice Address - Street 1:4901 MARKET PLACE RD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8986
Practice Address - Country:US
Practice Address - Phone:855-527-7246
Practice Address - Fax:833-810-1165
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA2831363A00000X
390200000X
ALPA2022363A00000X
FLPA9116124363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300058643Medicaid
KYK401990OtherKY MEDICARE