Healthcare Provider Details

I. General information

NPI: 1306977939
Provider Name (Legal Business Name): MARCIA LYNN HANSEN C.N.M.,N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 POTRERO AVE # 6D-21 SFGH MIDWIFERY SERVICE
SAN FRANCISCO CA
94110-3518
US

IV. Provider business mailing address

PO BOX 99
LEGGETT CA
95585-0099
US

V. Phone/Fax

Practice location:
  • Phone: 415-206-5106
  • Fax:
Mailing address:
  • Phone: 707-925-6024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number83
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: