Basic Information
Provider Information
NPI: 1568694701
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: POWELL
FirstName: HANNAH
MiddleName: R
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: PHILLIPS
OtherFirstName: HANNAH
OtherMiddleName: R
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: CRNA
OtherLastNameType: 1
Mailing Information
Address1: 800 ROSE STREET, N212
Address2:  
City: LEXINGTON
State: KY
PostalCode: 405360293
CountryCode: US
TelephoneNumber: 8593235956
FaxNumber: 8593231080
Practice Location
Address1: 800 ROSE ST # N212
Address2:  
City: LEXINGTON
State: KY
PostalCode: 405360293
CountryCode: US
TelephoneNumber: 8593235956
FaxNumber: 8593231080
Other Information
ProviderEnumerationDate: 08/21/2009
LastUpdateDate: 02/16/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X3006141KYY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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