Provider Demographics
NPI:1912313404
Name:KINNEY, HANNAH MARIE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:MARIE
Last Name:KINNEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:MARIE
Other - Last Name:GNIZAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1042 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-3113
Mailing Address - Country:US
Mailing Address - Phone:734-240-4870
Mailing Address - Fax:734-682-5083
Practice Address - Street 1:5700 MONROE ST UNIT 103
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2771
Practice Address - Country:US
Practice Address - Phone:419-843-7996
Practice Address - Fax:419-841-7704
Is Sole Proprietor?:No
Enumeration Date:2014-07-07
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601006962363A00000X
OH004012363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant