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Individual
MRS. TINA GAYLE HANNER
Active
Individual
MRS. TINA GAYLE HANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
661717
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
328273301
—
TX
05
—
328273302
—
TX
01
—
75-2616977-043
TRICARE
TX
01
—
75-2616977-066
TRICARE
TX
01
—
75-2771569-005
TRICARE
TX
01
—
8583ND
BCBS
TX
01
—
8638MC
BCBS
TX
01
—
P01280555
RAIL ROAD
TX
01
—
P01812452
RAIL ROAD MEDICARE
TX
Enumeration date
09/18/2013
Last updated
05/08/2017
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