Provider Demographics
NPI:1770919516
Name:RICHARDS, HANNAH LEIGH (PA)
Entity type:Individual
Prefix:MS
First Name:HANNAH
Middle Name:LEIGH
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 MEDICAL PKWY STE 600
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3748
Mailing Address - Country:US
Mailing Address - Phone:443-481-6699
Mailing Address - Fax:
Practice Address - Street 1:2000 MEDICAL PKWY STE 600
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3748
Practice Address - Country:US
Practice Address - Phone:443-481-6699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-25
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0005505363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNAPPINPROCESSOtherTN MEDICARE
TNQ036466Medicaid