Healthcare Provider Details

I. General information

NPI: 1104615566
Provider Name (Legal Business Name): KARA JEAN ROBINSON HANSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2025
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2705 GILBERT AVE
MISSOULA MT
59802-3203
US

IV. Provider business mailing address

2705 GILBERT AVE
MISSOULA MT
59802-3203
US

V. Phone/Fax

Practice location:
  • Phone: 406-552-2045
  • Fax:
Mailing address:
  • Phone: 406-552-2045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberNUR-RN-LIC-36034
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberNUR-RN-LIC-36034
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number269259
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: