Provider Demographics
NPI:1992465652
Name:KING, HANNAH L (PA)
Entity type:Individual
Prefix:MS
First Name:HANNAH
Middle Name:L
Last Name:KING
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1010 LAWRENCE STREET
Mailing Address - Street 2:
Mailing Address - City:BRANDENBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40108-1401
Mailing Address - Country:US
Mailing Address - Phone:270-422-3400
Mailing Address - Fax:270-422-3473
Practice Address - Street 1:1010 LAWRENCE STREET
Practice Address - Street 2:
Practice Address - City:BRANDENBURG
Practice Address - State:KY
Practice Address - Zip Code:40108-1401
Practice Address - Country:US
Practice Address - Phone:270-422-3400
Practice Address - Fax:270-422-3473
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-22
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KYPA2982363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty