Provider Demographics
NPI:1962116848
Name:KEATING, HANNAH FITZGERALD
Entity type:Individual
Prefix:MS
First Name:HANNAH
Middle Name:FITZGERALD
Last Name:KEATING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:388 S MAIN ST # 207
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44311-1064
Mailing Address - Country:US
Mailing Address - Phone:330-773-7866
Mailing Address - Fax:
Practice Address - Street 1:1077 GORGE BLVD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-2408
Practice Address - Country:US
Practice Address - Phone:330-375-4045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-05
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.008823RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant