Basic Information
Provider Information
NPI: 1497480503
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NASON
FirstName: HANNAH
MiddleName:  
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Credential:  
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Mailing Information
Address1: 599C STEED RD
Address2:  
City: RIDGELAND
State: MS
PostalCode: 391571707
CountryCode: US
TelephoneNumber: 6016056777
FaxNumber:  
Practice Location
Address1: 4215 LAKELAND DR
Address2:  
City: FLOWOOD
State: MS
PostalCode: 392329212
CountryCode: US
TelephoneNumber: 6019328555
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/21/2022
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 07/21/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
224Z00000XOTA3699MSY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant 

No ID Information.


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