Healthcare Provider Details

I. General information

NPI: 1396278917
Provider Name (Legal Business Name): EMILY NICOLE HANSEN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2017
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 RAINBOW BLVD
KANSAS CITY KS
66160-1167
US

IV. Provider business mailing address

3901 RAINBOW BLVD MAIL STOP 1020
KANSAS CITY KS
66160
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-3807
  • Fax: 913-588-0593
Mailing address:
  • Phone: 913-588-0348
  • Fax: 913-588-0593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number2020022445
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number05-44760
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: