Provider Demographics
NPI:1447666086
Name:HANAWAY, KEVIN PATRICK (DNP, MBA, APRN)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:PATRICK
Last Name:HANAWAY
Suffix:
Gender:M
Credentials:DNP, MBA, APRN
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Mailing Address - Street 1:1601 CLINT MOORE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-2768
Mailing Address - Country:US
Mailing Address - Phone:561-939-0200
Mailing Address - Fax:561-939-0271
Practice Address - Street 1:1601 CLINT MOORE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-2768
Practice Address - Country:US
Practice Address - Phone:561-939-0200
Practice Address - Fax:561-939-0271
Is Sole Proprietor?:No
Enumeration Date:2014-07-03
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN3361362363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology