Healthcare Provider Details

I. General information

NPI: 1760534598
Provider Name (Legal Business Name): LOUISE O HANSON CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. LOUISE D O'CONNER

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 10/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 MEDICAL PKWY 520
ANNAPOLIS MD
21401-3046
US

IV. Provider business mailing address

2002 MEDICAL PKWY 520
ANNAPOLIS MD
21401-3046
US

V. Phone/Fax

Practice location:
  • Phone: 410-573-8430
  • Fax: 410-573-5981
Mailing address:
  • Phone: 410-573-8430
  • Fax: 410-573-5981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number0363195
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: