Individual
JACEY HANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP, NP-C
Contact information
Practice address
1501 GOLDEN GATE PLZ, MAYFIELD HEIGHTS, OH 44124-3415
(440) 499-4076
Mailing address
8644 RANCH DR, CHESTERLAND, OH 44026-3132
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.026423
OH
Other
Enumeration date
03/06/2020
Last updated
03/06/2020
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