Provider Demographics
NPI:1306250865
Name:SUTTON, HANNAH ROSE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:ROSE
Last Name:SUTTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:HANNAH
Other - Middle Name:ROSE
Other - Last Name:PENNY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:710 FALLS BLVD S
Mailing Address - Street 2:
Mailing Address - City:WYNNE
Mailing Address - State:AR
Mailing Address - Zip Code:72396-3514
Mailing Address - Country:US
Mailing Address - Phone:870-238-2321
Mailing Address - Fax:
Practice Address - Street 1:710 FALLS BLVD S
Practice Address - Street 2:
Practice Address - City:WYNNE
Practice Address - State:AR
Practice Address - Zip Code:72396-3514
Practice Address - Country:US
Practice Address - Phone:870-238-2321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP-T1427363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant