Provider Demographics
NPI:1679261945
Name:HANES, CARA LEEANN
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:LEEANN
Last Name:HANES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10861 RAPP RD
Mailing Address - Street 2:
Mailing Address - City:NEW MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44442-8709
Mailing Address - Country:US
Mailing Address - Phone:330-718-5387
Mailing Address - Fax:
Practice Address - Street 1:10861 RAPP RD
Practice Address - Street 2:
Practice Address - City:NEW MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:44442-8709
Practice Address - Country:US
Practice Address - Phone:330-718-5387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion