Healthcare Provider Details

I. General information

NPI: 1316150279
Provider Name (Legal Business Name): PATTY STAHLE HANSEN RXN CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 04/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9485 W COLFAX
LAKEWOOD CO
80215
US

IV. Provider business mailing address

9485 W COLFAX
LAKEWOOD CO
80215
US

V. Phone/Fax

Practice location:
  • Phone: 303-432-5200
  • Fax: 303-432-5260
Mailing address:
  • Phone: 303-432-5200
  • Fax: 303-432-5260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberRXN05024
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: