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NPI Code Detail

MEDICARE: MS. MARY FRANCES HANSEN

MEDICARE: MS. MARY FRANCES HANSEN
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
1363LF0000XFamily Nurse PractitionerAZ

General Provider Information

NPI Number : 1144256165
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY FRANCES HANSEN
Provider Business Mailing Address
First Line : 4223 N LONGVIEW AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85014-4526
Country : US
Telephone Number : 602-274-1271
Fax Number :
Provider Business Practice Location Address
First Line : 650 E INDIAN SCHOOL RD
Second Line : PRE-PROCEDURE CLINIC 112-B
City : PHOENIX
State : AZ
Zip : 85012-1839
Country : US
Telephone Number : 602-277-5551
Fax Number : 602-200-6033
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2006
Last Update Date : 07/08/2007

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