Provider Demographics
NPI:1699162529
Name:WACHTMEISTER, HANNAH LOUISE (NP)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:LOUISE
Last Name:WACHTMEISTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:881 PROFESSIONAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-5257
Mailing Address - Country:US
Mailing Address - Phone:931-645-4685
Mailing Address - Fax:931-245-2117
Practice Address - Street 1:881 PROFESSIONAL PARK DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-5257
Practice Address - Country:US
Practice Address - Phone:931-645-4685
Practice Address - Fax:931-245-2117
Is Sole Proprietor?:No
Enumeration Date:2015-04-17
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19366363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics