MEDICARE: ANNA K HANSON FNP-BC, CNM

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
1	363LF0000X	Family Nurse Practitioner	AP0693	AZ
2	367A00000X	Advanced Practice Midwife	RN036650-AP8139	AZ

General Provider Information

NPI Number	:	1326032483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA K HANSON FNP-BC, CNM

Provider Business Mailing Address
First Line	:	4338 W THOMAS RD
Second Line	:	SUITE # 117
City	:	PHOENIX
State	:	AZ
Zip	:	85031-3878
Country	:	US
Telephone Number	:	602-429-2239
Fax Number	:	602-559-5436

Provider Business Practice Location Address
First Line	:	4338 W THOMAS RD
Second Line	:	SUITE # 117
City	:	PHOENIX
State	:	AZ
Zip	:	85031-3878
Country	:	US
Telephone Number	:	602-429-2239
Fax Number	:	602-559-5436

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2005
Last Update Date	:	01/06/2016

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