Provider Demographics
NPI:1932815800
Name:JACOB, HANNAH LETOURNEAU (APRN)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:LETOURNEAU
Last Name:JACOB
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:CHRISTINE
Other - Last Name:LETOURNEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:244 SAINT ANN DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-1114
Mailing Address - Country:US
Mailing Address - Phone:931-801-3816
Mailing Address - Fax:
Practice Address - Street 1:2408 SIR BARTON WAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-8300
Practice Address - Country:US
Practice Address - Phone:859-229-5198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-25
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3018948363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily