Provider Demographics
NPI:1215756523
Name:RODEN, HANNAH RAE (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:RAE
Last Name:RODEN
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 W CHAMBERS
Mailing Address - Street 2:
Mailing Address - City:ITALY
Mailing Address - State:TX
Mailing Address - Zip Code:76651-3500
Mailing Address - Country:US
Mailing Address - Phone:972-351-7425
Mailing Address - Fax:
Practice Address - Street 1:304 ADMINISTRATION DR
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76209-2098
Practice Address - Country:US
Practice Address - Phone:940-898-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-04
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1003300363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner