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General NPI Number Information
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NPI Number | 1831646843
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Entity Type | Individual
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Provider Name | ANDREW HANSEN PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/07/2016
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 3448 S 3200 W
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City | WEST VALLEY CITY
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State | UT
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Zip | 84119-2628
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Country | US
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Telephone | 801-359-2256
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Fax | 801-364-4392
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Provider Business Mailing Address
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Address Line | 13594 S HEATHER DAISY DR
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City | HERRIMAN
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State | UT
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Zip | 84096-3300
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Country | US
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Telephone | 661-204-6732
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 13933798-1206
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA56261
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License Number State | CA
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