Provider Demographics
NPI:1285298190
Name:MCCALLUM, HANNAH MARIE (NP)
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:MARIE
Last Name:MCCALLUM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:HANNAH
Other - Middle Name:MARIE
Other - Last Name:BIENHOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:107 MCLEOD HEALTH BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-4477
Mailing Address - Country:US
Mailing Address - Phone:843-839-1201
Mailing Address - Fax:843-739-1202
Practice Address - Street 1:107 MCLEOD HEALTH BLVD STE 202
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29579-4477
Practice Address - Country:US
Practice Address - Phone:843-839-1201
Practice Address - Fax:843-839-1202
Is Sole Proprietor?:No
Enumeration Date:2019-04-25
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22427363L00000X
NC5011647363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner