Individual
HANNAH KATHLEEN PROULX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 713-9800
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2011
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-05008
NC
363A00000X
Physician Assistant
0110005756
VA
363A00000X
Physician Assistant
PA9107279
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009226200
—
FL
Enumeration date
07/19/2013
Last updated
05/17/2022
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