Healthcare Provider Details

I. General information

NPI: 1346596814
Provider Name (Legal Business Name): SHARONAH MAGDALEN HANSON FAMILY PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2012
Last Update Date: 05/19/2021
Certification Date: 05/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7530 E ANGUS DR
SCOTTSDALE AZ
85251-6410
US

IV. Provider business mailing address

3211 E PINCHOT AVE APT 325
PHOENIX AZ
85018-8415
US

V. Phone/Fax

Practice location:
  • Phone: 480-712-4210
  • Fax:
Mailing address:
  • Phone: 480-712-4210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP4586
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: