Healthcare Provider Details

I. General information

NPI: 1801121991
Provider Name (Legal Business Name): PAMELA JEAN HANSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2009
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 STEFFEN AVE
CINCINNATI OH
45215-2338
US

IV. Provider business mailing address

1401 STEFFEN AVE
CINCINNATI OH
45215-2338
US

V. Phone/Fax

Practice location:
  • Phone: 513-728-3999
  • Fax:
Mailing address:
  • Phone: 513-330-8293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number35050843
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number35.050843
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: