Provider Demographics
NPI:1720727340
Name:HANNA, ALEXANDRA (CRNA)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:
Last Name:HANNA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7009 BLACK CREEK CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLET
Mailing Address - State:GA
Mailing Address - Zip Code:30415-6558
Mailing Address - Country:US
Mailing Address - Phone:912-405-4289
Mailing Address - Fax:
Practice Address - Street 1:11705 MERCY BLVD
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419-1711
Practice Address - Country:US
Practice Address - Phone:912-405-4289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN254868367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered