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General NPI Number Information
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NPI Number | 1548086242
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Entity Type | Individual
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Provider Name | JAMIE A HANSON AGNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/26/2024
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 10 MAPLE AVE STE 300
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City | GREAT BARRINGTON
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State | MA
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Zip | 01230-1993
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Country | US
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Telephone | 413-854-9932
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Fax | 413-854-9931
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Provider Business Mailing Address
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Address Line | 1980 CAPE ST
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City | LEE
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State | MA
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Zip | 01238-9114
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Country | US
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Telephone | 413-770-1240
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN270821
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License Number State | MA
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