Provider Demographics
NPI:1972614824
Name:HANNA, DIANE M (ARNP)
Entity type:Individual
Prefix:MS
First Name:DIANE
Middle Name:M
Last Name:HANNA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6730 W 121ST ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-2002
Mailing Address - Country:US
Mailing Address - Phone:913-387-1120
Mailing Address - Fax:913-631-6222
Practice Address - Street 1:6730 W 121ST ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-2002
Practice Address - Country:US
Practice Address - Phone:913-387-1120
Practice Address - Fax:913-387-1120
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45947363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner