Provider Demographics
NPI:1124816046
Name:HANNA, LASHAE ALEXANDRA LEE
Entity type:Individual
Prefix:
First Name:LASHAE
Middle Name:ALEXANDRA LEE
Last Name:HANNA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 21ST AVE N APT 244
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-6140
Mailing Address - Country:US
Mailing Address - Phone:210-379-2628
Mailing Address - Fax:
Practice Address - Street 1:640 21ST AVE N APT 244
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-6140
Practice Address - Country:US
Practice Address - Phone:210-379-2628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN279068163W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No163W00000XNursing Service ProvidersRegistered Nurse