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NPI Code Detail

MEDICARE: ELISABETH ANNE HANSEN FNP-C

MEDICARE: ELISABETH ANNE HANSEN FNP-C
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 Practitioner53-76817-051KS
2363LF0000XFamily Nurse PractitionerAP60698673WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356727069
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELISABETH ANNE HANSEN FNP-C
Provider Business Mailing Address
First Line : 1044 11TH AVE
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-2506
Country : US
Telephone Number : 360-575-8275
Fax Number : 360-575-8275
Provider Business Practice Location Address
First Line : 1044 11TH AVE
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-2506
Country : US
Telephone Number : 360-575-8275
Fax Number : 360-575-1943
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2015
Last Update Date : 12/10/2025

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