Individual
KELLY HANNAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2959 ALAFAYA TRL STE 121, OVIEDO, FL 32765-9482
(407) 986-1360
Mailing address
PO BOX 622168, OVIEDO, FL 32762-2168
(954) 610-8420
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11020170
FL
Other
Enumeration date
06/08/2022
Last updated
06/16/2022
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