Individual
JESSICA ANN HANNAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2095 HENRY TECKLENBURG DR, CHARLESTON, SC 29414-5733
(843) 402-5035
(843) 402-5036
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(843) 789-1620
(843) 724-2440
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
33596
SC
2084N0400X
Neurology Physician
DR.0056849
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
335961
—
SC
Enumeration date
06/07/2011
Last updated
11/20/2020
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