Angela Michelle Hannah, PA-C
Physician Assistant in Hesperia, MI. Individual provider (NPI-1).
NPI number1679908552
StatusActive
Last updated in NPPESMar 30, 2022
Details
- NPI
- 1679908552
- Entity type
- Individual (NPI-1)
- Name
- Angela Michelle Hannah
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 10, 2013
- Certification date
- Mar 30, 2022
- Last updated
- Mar 30, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 5601006764 | MI | Yes |
Other names
- Angela Michelle Derrick (Former Name)
Practice location
78 N Division StHesperia, MI 49421-5100
Phone 231-854-6415 · Fax 231-854-6975
Mailing address
100 Michigan St NeMc 845
Grand Rapids, MI 49503-2560
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