Provider Demographics
NPI:1255197554
Name:PARKER, HANNAH FAITH
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:FAITH
Last Name:PARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 CYPRESS RD APT 409
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-3079
Mailing Address - Country:US
Mailing Address - Phone:660-292-0440
Mailing Address - Fax:
Practice Address - Street 1:10301 HAGEN RANCH RD STE D720
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3777
Practice Address - Country:US
Practice Address - Phone:561-532-1462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9118500363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant