Provider Demographics
NPI:1861902157
Name:MARTIN, HANNAH ELLEN (PA-C)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:ELLEN
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80040-0060
Mailing Address - Country:US
Mailing Address - Phone:720-777-4985
Mailing Address - Fax:720-777-7268
Practice Address - Street 1:CHILDREN'S HOSPITAL COLORADO 13123 EAST 16TH AVENUE
Practice Address - Street 2:BOX 060
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-0600
Practice Address - Country:US
Practice Address - Phone:720-777-4985
Practice Address - Fax:720-777-7268
Is Sole Proprietor?:No
Enumeration Date:2017-10-02
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0005098363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical