Provider Demographics
NPI:1205446770
Name:EUBANKS, HANNAH NELL
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:NELL
Last Name:EUBANKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465280 E 810 RD
Mailing Address - Street 2:
Mailing Address - City:STILWELL
Mailing Address - State:OK
Mailing Address - Zip Code:74960-4439
Mailing Address - Country:US
Mailing Address - Phone:918-575-0287
Mailing Address - Fax:
Practice Address - Street 1:1418 W HICKORY ST
Practice Address - Street 2:
Practice Address - City:STILWELL
Practice Address - State:OK
Practice Address - Zip Code:74960-3247
Practice Address - Country:US
Practice Address - Phone:191-879-7778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-08
Last Update Date:2020-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator