Provider Demographics
NPI:1760345037
Name:HANNAH, EMILY DENISE
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:DENISE
Last Name:HANNAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5055 SAINT PATRICK CIR
Mailing Address - Street 2:
Mailing Address - City:CROSS LANES
Mailing Address - State:WV
Mailing Address - Zip Code:25313-3501
Mailing Address - Country:US
Mailing Address - Phone:304-202-3864
Mailing Address - Fax:
Practice Address - Street 1:5055 SAINT PATRICK CIR
Practice Address - Street 2:
Practice Address - City:CROSS LANES
Practice Address - State:WV
Practice Address - Zip Code:25313-3501
Practice Address - Country:US
Practice Address - Phone:304-202-3864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-12-04
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV50996904364SH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome Health