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Jacqueline Hannah
NPI 1528447471 · on the registry since 2015 · sole proprietor
Practice
- Address
- 924 Broadmoor Dr
Indianola, MS 38751 - Phone
- (662) 207-9842
- Organisation at this address
- Elise'S Place Adc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 3104A0630X
3104A0630X
- Also registered as
- 261QA0600X
- Licence states on file
- MS
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2017-03-09
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Mississippi