Provider Demographics
NPI:1629733167
Name:NEAL, HANNA
Entity type:Individual
Prefix:
First Name:HANNA
Middle Name:
Last Name:NEAL
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 1:1211 S EATON ST UNIT 7012
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-4384
Mailing Address - Country:US
Mailing Address - Phone:985-768-1795
Mailing Address - Fax:
Practice Address - Street 1:1460 RITCHIE HWY STE 103
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012-2704
Practice Address - Country:US
Practice Address - Phone:443-949-8373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-31
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN45579183500000X
MD29478183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist