Provider Demographics
NPI:1174709364
Name:WIMSATT, HANNAH M (ARNP)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:M
Last Name:WIMSATT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:M
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1215 OLD MAIN ST
Mailing Address - Street 2:DOCTORS BUILDING
Mailing Address - City:HARTFORD
Mailing Address - State:KY
Mailing Address - Zip Code:42347-1619
Mailing Address - Country:US
Mailing Address - Phone:270-298-5404
Mailing Address - Fax:270-295-5285
Practice Address - Street 1:1215 OLD MAIN ST
Practice Address - Street 2:DOCTORS BUILDING
Practice Address - City:HARTFORD
Practice Address - State:KY
Practice Address - Zip Code:42347-1619
Practice Address - Country:US
Practice Address - Phone:270-298-5404
Practice Address - Fax:270-295-5285
Is Sole Proprietor?:No
Enumeration Date:2008-01-17
Last Update Date:2008-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5054P363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily