Basic Information
Provider Information
NPI: 1376178798
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCCALL
FirstName: HANNAH
MiddleName: LYNN
NamePrefix: MRS.
NameSuffix:  
Credential: MSN, FNP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3333 RIVERWOOD PKWY SE STE 250
Address2:  
City: ATLANTA
State: GA
PostalCode: 303393304
CountryCode: US
TelephoneNumber: 4706153389
FaxNumber: 7709554276
Practice Location
Address1: 6175 NEWTON DR NE
Address2:  
City: COVINGTON
State: GA
PostalCode: 300142690
CountryCode: US
TelephoneNumber: 6783426000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/05/2020
LastUpdateDate: 07/20/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/20/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XRN244738GAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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