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Individual

CHRISTINE E HANNA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
4123 UNIVERSITY BLVD S, STE B, JACKSONVILLE, FL 32216
(904) 636-9100
(904) 636-9102
Mailing address
4123 UNIVERSITY BLVD S, STE B, JACKSONVILLE, FL 32216
(904) 636-9100
(904) 636-9102

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9105767
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PENDING
FL
Enumeration date
11/11/2010
Last updated
11/06/2019
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