Provider Demographics
NPI:1942074075
Name:WELLS, HANNAH MARIE (PA)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:MARIE
Last Name:WELLS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:MARIE
Other - Last Name:STARNES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:791 NEW HIGHWAY 68 STE 1
Mailing Address - Street 2:
Mailing Address - City:SWEETWATER
Mailing Address - State:TN
Mailing Address - Zip Code:37874-1906
Mailing Address - Country:US
Mailing Address - Phone:423-836-9304
Mailing Address - Fax:
Practice Address - Street 1:791 NEW HIGHWAY 68 STE 1
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:TN
Practice Address - Zip Code:37874-1906
Practice Address - Country:US
Practice Address - Phone:423-836-9304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-09
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA0000005790363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant