Provider Demographics
NPI:1831347178
Name:HANNA, KATRINA (CNM, ARNP)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:HANNA
Suffix:
Gender:F
Credentials:CNM, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4465 CORDATA PKWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-8037
Mailing Address - Country:US
Mailing Address - Phone:360-725-5280
Mailing Address - Fax:360-725-5282
Practice Address - Street 1:4465 CORDATA PKWY
Practice Address - Street 2:SUITE C
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-8037
Practice Address - Country:US
Practice Address - Phone:360-752-5280
Practice Address - Fax:360-752-5282
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60036287367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife