Provider Demographics
NPI:1053193805
Name:MCMAHAN, HANNAH GRACE (PA-C)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:GRACE
Last Name:MCMAHAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 SAMUEL DR APT 216
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-2216
Mailing Address - Country:US
Mailing Address - Phone:763-516-3353
Mailing Address - Fax:
Practice Address - Street 1:2000 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-5050
Practice Address - Country:US
Practice Address - Phone:563-589-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-17
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant