Individual provider · Type 1 NPI

Autumn Marie Hanna, PA

Physician Assistant · South Bend, IN

NPI number 1003677964 Active

Practice location

211 N Eddy St
South Bend, IN 46617-2808

Call (574) 234-8161 Map

Mailing address

26621 Hamilton St
Edwardsburg, MI 49112-9691

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XNone listed

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1003677964

Autumn Marie Hanna, PA's National Provider Identifier is 1003677964, issued on Jan 18, 2024. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in South Bend, IN. The record was last updated on Aug 19, 2025.