Healthcare Provider Details

I. General information

NPI: 1356314561
Provider Name (Legal Business Name): CANDACE JANE HANSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 JARRETT WHITE RD TRIPLER ARMY MEDICAL CENTER ATTN:MCHK-QS
TRIPLER AMC HI
96859-5001
US

IV. Provider business mailing address

95-209 KAELA PL
MILILANI HI
96789-6516
US

V. Phone/Fax

Practice location:
  • Phone: 808-433-2460
  • Fax: 808-433-1558
Mailing address:
  • Phone: 254-541-7372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number57663
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: