Provider Demographics
NPI:1114789948
Name:MCMANNES, HANNAH G O (PA-C)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:G O
Last Name:MCMANNES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:G
Other - Last Name:OSCARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:16901 LAKESIDE HILLS CT
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-2318
Mailing Address - Country:US
Mailing Address - Phone:855-524-4001
Mailing Address - Fax:402-717-7340
Practice Address - Street 1:16901 LAKESIDE HILLS CT
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-2318
Practice Address - Country:US
Practice Address - Phone:855-524-4001
Practice Address - Fax:402-717-7340
Is Sole Proprietor?:No
Enumeration Date:2024-01-26
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA124166363AM0700X
NE3030363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical