Provider Demographics
NPI:1861194011
Name:MATTIX, HANNAH (APRN-CNP, RN)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:MATTIX
Suffix:
Gender:F
Credentials:APRN-CNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-1633
Mailing Address - Country:US
Mailing Address - Phone:330-509-3758
Mailing Address - Fax:
Practice Address - Street 1:6480 ROCKSIDE WOODS BLVD S STE 330
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-2222
Practice Address - Country:US
Practice Address - Phone:855-490-9434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.502093163W00000X
OHAPRN.CNP.0034664363LG0600X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology