Provider Demographics
NPI:1740086602
Name:PULLENS, HASANA
Entity type:Individual
Prefix:MS
First Name:HASANA
Middle Name:
Last Name:PULLENS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 N WESTOVER BLVD APT 1324
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-1938
Mailing Address - Country:US
Mailing Address - Phone:702-337-9723
Mailing Address - Fax:
Practice Address - Street 1:504 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31705-2796
Practice Address - Country:US
Practice Address - Phone:229-500-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program