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General NPI Number Information
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NPI Number | 1306810684
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Entity Type | Individual
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Provider Name | KRISTINA D. HANSEN MD
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Gender | Female
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Dates
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Enumeration Date | 02/14/2006
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Last Update Date | 11/12/2009
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Provider Practice Location Address
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Address Line | 975 RYLAND ST SUITE 100
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City | RENO
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State | NV
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Zip | 89502-1667
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Country | US
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Telephone | 775-982-5210
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Fax | 775-982-5220
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Provider Business Mailing Address
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Address Line | 780 KUENZLI ST SUITE 202
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City | RENO
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State | NV
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Zip | 89502-0845
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Country | US
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Telephone | 775-982-4590
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Fax | 775-982-4595
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 10375
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License Number State | NV
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