Healthcare Provider Details

I. General information

NPI: 1346362258
Provider Name (Legal Business Name): GILLIAN SCOTT HANS CNM, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

464 77TH ST
BROOKLYN NY
11209-3206
US

IV. Provider business mailing address

464 77TH ST
BROOKLYN NY
11209-3206
US

V. Phone/Fax

Practice location:
  • Phone: 718-680-8383
  • Fax: 718-836-2063
Mailing address:
  • Phone: 718-680-8383
  • Fax: 718-836-2063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License NumberF001030-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number360487
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: