Healthcare Provider Details

I. General information

NPI: 1053417857
Provider Name (Legal Business Name): SUSAN R HANSFORD-ORSBURN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUSAN R HANSFORD FNP

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 04/27/2022
Certification Date: 04/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 E BYPASS 287
ALVORD TX
76225-7778
US

IV. Provider business mailing address

115 E BYPASS 287
ALVORD TX
76225-7778
US

V. Phone/Fax

Practice location:
  • Phone: 940-428-2858
  • Fax: 866-241-2533
Mailing address:
  • Phone: 940-427-2858
  • Fax: 940-627-7464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP106807
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP106807
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number254192
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: