Provider Demographics
NPI:1154039840
Name:BYRD, HANNA (CFNP)
Entity type:Individual
Prefix:
First Name:HANNA
Middle Name:
Last Name:BYRD
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 COUNTY ROAD 1250
Mailing Address - Street 2:
Mailing Address - City:BOONEVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38829-8661
Mailing Address - Country:US
Mailing Address - Phone:662-416-6215
Mailing Address - Fax:
Practice Address - Street 1:109 NORTH RD
Practice Address - Street 2:
Practice Address - City:BOONEVILLE
Practice Address - State:MS
Practice Address - Zip Code:38829-7615
Practice Address - Country:US
Practice Address - Phone:662-728-2914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS905674363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily