Provider Demographics
NPI:1053799387
Name:HANNING, PATRICIA (IBCLC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:HANNING
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2906 TRINITY COTTAGE DR
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-8134
Mailing Address - Country:US
Mailing Address - Phone:813-505-6491
Mailing Address - Fax:
Practice Address - Street 1:2906 TRINITY COTTAGE DR
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-8134
Practice Address - Country:US
Practice Address - Phone:813-505-6491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-06
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL-11398174N00000X
FLRN9316706163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No163W00000XNursing Service ProvidersRegistered Nurse