Provider Demographics
NPI:1720829708
Name:SCHENK, HANNAH ELLEN (PA-C)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:ELLEN
Last Name:SCHENK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2242 SUN VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91915-2224
Mailing Address - Country:US
Mailing Address - Phone:619-616-1563
Mailing Address - Fax:
Practice Address - Street 1:3210 AVALON DR
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-7609
Practice Address - Country:US
Practice Address - Phone:619-616-1563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant