Provider Demographics
NPI:1265514616
Name:HANUS, THERESA MARIE (RN)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:MARIE
Last Name:HANUS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:THERESA
Other - Middle Name:MARIE
Other - Last Name:SKUNZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:205 THORNAPPLE TRL
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-3718
Mailing Address - Country:US
Mailing Address - Phone:859-312-2435
Mailing Address - Fax:
Practice Address - Street 1:250 HENRY ST
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OK
Practice Address - Zip Code:43015
Practice Address - Country:US
Practice Address - Phone:740-369-4482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH138596163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent