Vivian N Hannon
Organization Active NPI Family Nurse Practitioner · Laceys Spring, AL
NPI 1356512883 · NPPES record last updated Mar 12, 2008
Key facts
- NPI
- 1356512883
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 1-057030 (AL)
- Legal business name
- VIVIAN N HANNON
- Practice address
- 4258 Highway 231
Laceys Spring, AL 35754-6448 - Phone
- (256) 498-5770
- NPI assigned
- Mar 12, 2008
- Organization subpart
- No
Authorized official
- Name
- Mr. Mark Christopher Hannon
- Title
- Office Manager
- Phone
- (256) 498-5770
Other NPIs on the same Medicare enrollment 4
Practitioners 3
-
Vivian Nell Hannon, CRNP
-
Rebecca Dianna Worsham, CRNP
-
Kristina Smith, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041110001067 | AL | Part B Supplier - Clinic/Group Practice | 6002879913 |
Receives reassigned benefits from 7 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Guntersville, AL |
National Provider Directory
Locations
1241 Blount Ave
Guntersville, AL 35976
Phone (256) 582-6377
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | 1-057030 | AL | Yes |
Addresses
Primary practice location
4258 Highway 231
Laceys Spring, AL 35754-6448
Mailing address
1241 Blount Ave
Guntersville, AL 35976-1831
Phone (256) 582-6377
Other names
- Brindlee Mtn Family Practice Clinic
Other providers in Laceys Spring, AL
- Jeannie Johnston
- Leslie Lalane Phillips
- Valley Sunrise LLC
- Leah Tucker Walsh
- Catharine B Willis
- Tammy Lynn Wilson
- Breanna Wootson
- Rebecca Dianna Worsham
All providers in Laceys Spring, AL · Family Nurse Practitioner in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.