Individual
JENNIFER L HANNUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
WAKE FOREST UNIVERSITY HEALTH SCIENCES, MEDICAL CENTER BOULEVARD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON-SALEM, NC 27102-0001
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2007-01370
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146F4
BCBS
NC
05
—
1639273634
—
VA
01
—
202020
MEDCOST
NC
05
—
5908092
—
NC
01
—
810636
PARTNERS
NC
01
—
9772074
AETNA
NC
05
—
Q0137D
—
SC
Enumeration date
09/11/2006
Last updated
08/20/2010
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