Healthcare Provider Details

I. General information

NPI: 1407586969
Provider Name (Legal Business Name): RACHEL MARISSA HANSEN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2022
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 CUMMINGS RD
HANOVER NH
03755-1218
US

IV. Provider business mailing address

PO BOX 810
HANOVER NH
03755-0810
US

V. Phone/Fax

Practice location:
  • Phone: 603-653-8525
  • Fax: 603-643-7343
Mailing address:
  • Phone: 603-653-8525
  • Fax: 603-643-7343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number071715-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: