Individual provider Active NPI

Marie Jordan Hanna, BSN, MSN, CRNP

  • Pediatric Nurse Practitioner
  • Alexander City, AL
National Provider Identifier
1760748503
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1-111571 Issued in AL
Practice address
239 Church St Ste a
Alexander City, AL 35010-2517
Phone
(256) 234-4443
Fax
(256) 234-3686
NPI assigned
Apr 5, 2012
Last updated
Jan 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 1-111571 AL Primary

Addresses

Primary practice location

239 Church St Ste a
Alexander City, AL 35010-2517

Mailing address

PO Box 2008
Alexander City, AL 35011-2008
Phone (256) 234-4443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20180719002321 AL Practitioner - Nurse Practitioner 7719234962

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-111571ALMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tadpole Pediatrics, LLC CurrentSince Apr 9, 2023 Accepting new patients

Locations

239 Church St
Ste A
Alexander City, AL 35010
Phone (256) 234-4404

44 Aliant Pkwy
Alexander City, AL 35010
Phone (256) 234-4131

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": "1333584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1760748503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2008",
            "city": "ALEXANDER CITY",
            "state": "AL",
            "postal_code": "350112008",
            "telephone_number": "256-234-4443",
            "fax_number": "256-234-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 CHURCH ST STE A",
            "city": "ALEXANDER CITY",
            "state": "AL",
            "postal_code": "350102517",
            "telephone_number": "256-234-4443",
            "fax_number": "256-234-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "MARIE",
        "middle_name": "JORDAN",
        "name_prefix": "Mrs.",
        "credential": "BSN, MSN, CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-05",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AL",
            "license": "1-111571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexander City, AL

Sources for this page

Verify at the official NPI Registry.