Provider Demographics
NPI:1538577234
Name:CURTIS, HANNAH RAE (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:RAE
Last Name:CURTIS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 N CAMELOT DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MO
Mailing Address - Zip Code:63379-2334
Mailing Address - Country:US
Mailing Address - Phone:314-753-1679
Mailing Address - Fax:
Practice Address - Street 1:12255 DEPAUL DRIVE
Practice Address - Street 2:SUITE 865
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044
Practice Address - Country:US
Practice Address - Phone:314-291-0505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-25
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014025532363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily