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NPI Code Detail

MEDICARE: MRS. KRISTIN LORRIE HANSEN DPT

MEDICARE: MRS. KRISTIN LORRIE HANSEN DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251S0007XSports Physical TherapistPT30641FL
2225100000XPhysical TherapistPT30641FL

General Provider Information

NPI Number : 1053785204
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KRISTIN LORRIE HANSEN DPT
Provider Business Mailing Address
First Line : 13960 PLANTATION RD
Second Line :
City : FORT MYERS
State : FL
Zip : 33912-4303
Country : US
Telephone Number : 239-343-1703
Fax Number : 239-343-4067
Provider Business Practice Location Address
First Line : 1402 SE 16TH PL
Second Line :
City : CAPE CORAL
State : FL
Zip : 33990-3819
Country : US
Telephone Number : 239-772-2363
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2015
Last Update Date : 02/19/2026

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