Individual
KELLY LEE HANNER
Active
Individual
KELLY LEE HANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN RN, LMT
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704280951
MI
163WM1400X
Nurse Massage Therapist (NMT)
4704280951
MI
171400000X
Health & Wellness Coach
—
—
174H00000X
Health Educator
Primary
—
—
225700000X
Massage Therapist
7501016036
MI
Other
Enumeration date
05/19/2025
Last updated
05/19/2025
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