Healthcare Provider Details

I. General information

NPI: 1134032394
Provider Name (Legal Business Name): HEATHER MARIE HANSEN PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 ANDERSON AVE STE 202
MANHATTAN KS
66502-2809
US

IV. Provider business mailing address

4643 S DWIGHT DR
MANHATTAN KS
66502-1418
US

V. Phone/Fax

Practice location:
  • Phone: 913-980-4939
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number53-86221-101
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: