Provider Demographics
NPI:1932308509
Name:HANNON, DEANNA LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:LYNN
Last Name:HANNON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 N CULLEN ST
Mailing Address - Street 2:PO BOX 262
Mailing Address - City:RENSSELAER
Mailing Address - State:IN
Mailing Address - Zip Code:47978-2007
Mailing Address - Country:US
Mailing Address - Phone:219-866-4145
Mailing Address - Fax:219-866-4145
Practice Address - Street 1:1031 N CULLEN ST
Practice Address - Street 2:
Practice Address - City:RENSSELAER
Practice Address - State:IN
Practice Address - Zip Code:47978-2007
Practice Address - Country:US
Practice Address - Phone:219-866-4145
Practice Address - Fax:219-866-4145
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002594A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor