Provider Demographics
NPI:1871475996
Name:HANNAH, JUNELL (NP)
Entity type:Individual
Prefix:
First Name:JUNELL
Middle Name:
Last Name:HANNAH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2877 DOLOSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-7661
Mailing Address - Country:US
Mailing Address - Phone:718-350-0061
Mailing Address - Fax:718-350-0061
Practice Address - Street 1:2877 DOLOSTONE WAY
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-7661
Practice Address - Country:US
Practice Address - Phone:718-350-0061
Practice Address - Fax:718-350-0061
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN270647163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent