Provider Demographics
NPI:1063262228
Name:HANNA, LUCINDA LEA
Entity type:Individual
Prefix:
First Name:LUCINDA
Middle Name:LEA
Last Name:HANNA
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:PO BOX 104
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:WV
Mailing Address - Zip Code:24946-0104
Mailing Address - Country:US
Mailing Address - Phone:304-646-7248
Mailing Address - Fax:
Practice Address - Street 1:58 PEACH STREET
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:WV
Practice Address - Zip Code:24946
Practice Address - Country:US
Practice Address - Phone:304-646-7248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist