Healthcare Provider Details

I. General information

NPI: 1265756100
Provider Name (Legal Business Name): APRIL M HANSEN RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2010
Last Update Date: 03/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5414 NE EVERETT STREET
PORTLAND OR
97213
US

IV. Provider business mailing address

5414 NE EVERETT STREET
PORTLAND OR
97213
US

V. Phone/Fax

Practice location:
  • Phone: 503-490-9631
  • Fax:
Mailing address:
  • Phone: 503-490-9631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number096007266RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: