Individual
MARY HANNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
131 S WASHINGTON ST, SLOCOMB, AL 36375-6198
(334) 258-4034
Mailing address
91 LAUREL BREEZE DR, ENTERPRISE, AL 36330-7841
(334) 406-9222
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-142923
AL
163W00000X
Registered Nurse
RN215194
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1-142923
AL
Other
Enumeration date
04/29/2014
Last updated
02/04/2026
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