Provider Demographics
NPI:1386609378
Name:HANNA, JULIE H (PAC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:H
Last Name:HANNA
Suffix:
Gender:F
Credentials:PAC
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Other - Credentials:
Mailing Address - Street 1:1305 WEBSTER RD
Mailing Address - Street 2:SENECA HEALTH SERVICES INC
Mailing Address - City:SUMMERSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26651
Mailing Address - Country:US
Mailing Address - Phone:304-872-6796
Mailing Address - Fax:304-872-5415
Practice Address - Street 1:100 CHURCH ST
Practice Address - Street 2:SENECA HEALTH SERVICES INC
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901
Practice Address - Country:US
Practice Address - Phone:304-645-3319
Practice Address - Fax:304-645-6532
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WV1055712363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q29131Medicare UPIN