Healthcare Provider Details

I. General information

NPI: 1851365563
Provider Name (Legal Business Name): LINDA R HANSON CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDA R GUNDERSON CNP

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 07/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 S MINNESOTA AVE
SIOUX FALLS SD
57108-2707
US

IV. Provider business mailing address

5000 S MINNESOTA AVE
SIOUX FALLS SD
57108-2707
US

V. Phone/Fax

Practice location:
  • Phone: 605-371-6899
  • Fax: 877-215-2301
Mailing address:
  • Phone: 605-371-6899
  • Fax: 877-215-2301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number199929112
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCNPCP000386
License Number StateSD
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR026343
License Number StateSD
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR1401378
License Number StateMN
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA098703
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: