Provider Demographics
NPI:1902340276
Name:ANTHONY, HANNAH LEIGH (RN, CPNP-PC)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:LEIGH
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:RN, CPNP-PC
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:450 BROOKLINE AVE # D-3138
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5450
Mailing Address - Country:US
Mailing Address - Phone:267-574-5051
Mailing Address - Fax:
Practice Address - Street 1:450 BROOKLINE AVE # D-3138
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5450
Practice Address - Country:US
Practice Address - Phone:617-632-3270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-06
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95005486363L00000X
MARN2303030363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner