NPI 1003677964

Autumn Marie Hanna, PA

Practitioner Physician Assistant South Bend, IN

Practice location

Address: 211 N Eddy St, South Bend, IN 46617-2808
Phone: (574) 234-8161
Mailing address: 26621 Hamilton St, Edwardsburg, MI 49112-9691

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X

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Registry record

NPI: 1003677964
Entity type: Individual
Sex (as registered): Female
NPI issued: 18 Jan 2024
Record last updated: 19 Aug 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.