Individual provider Active NPI

Hannah Leann Naude, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Pooler, GA
National Provider Identifier
1417454034
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN223253 Issued in GA
Practice address
6 Holmes CT Ste 100
Pooler, GA 31322-4801
Phone
(912) 254-4401
Fax
(912) 330-4319
NPI assigned
Apr 10, 2018
Last updated
Feb 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN223253 GA Primary

Addresses

Primary practice location

6 Holmes CT Ste 100
Pooler, GA 31322-4801

Mailing address

6 Holmes CT Ste 100
Pooler, GA 31322-4801
Phone (912) 254-4401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190220001561 GA Practitioner - Nurse Practitioner 5991043713 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN223253GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Recovery Network LLC CurrentSince Feb 24, 2022 Accepting new patients

Locations

6 Holmes Ct
Ste 100
Pooler, GA 31322
Phone (912) 254-4401

250 Corporate Center Ct
Stockbridge, GA 30281
Phone (770) 954-8685

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1417454034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 HOLMES CT STE 100",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224801",
            "telephone_number": "912-254-4401",
            "fax_number": "912-330-4319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 HOLMES CT STE 100",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224801",
            "telephone_number": "912-254-4401",
            "fax_number": "912-330-4319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAUDE",
        "first_name": "HANNAH",
        "middle_name": "LEANN",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-10",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN223253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pooler, GA

Sources for this page

Verify at the official NPI Registry.