Provider Demographics
NPI:1265313308
Name:MATTINGLY, HANNAH
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:MATTINGLY
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 1:4218 SAINT FRANCIS RD
Mailing Address - Street 2:
Mailing Address - City:SAINT FRANCIS
Mailing Address - State:KY
Mailing Address - Zip Code:40062-7046
Mailing Address - Country:US
Mailing Address - Phone:502-656-8540
Mailing Address - Fax:
Practice Address - Street 1:4218 SAINT FRANCIS RD
Practice Address - Street 2:
Practice Address - City:SAINT FRANCIS
Practice Address - State:KY
Practice Address - Zip Code:40062-7046
Practice Address - Country:US
Practice Address - Phone:502-656-8540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer