Healthcare Provider Details

I. General information

NPI: 1306806708
Provider Name (Legal Business Name): EMILY KAY HANSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 CENTER ST
COLUMBUS GA
31901-1527
US

IV. Provider business mailing address

115 BRIDLE PATH
ELLERSLIE GA
31807-5396
US

V. Phone/Fax

Practice location:
  • Phone: 706-571-1014
  • Fax:
Mailing address:
  • Phone: 706-568-6738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License NumberRN173406
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: