=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922770395
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTINA LOUISE HANSON RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/04/2021
-----------------------------------------------------
Last Update Date | 10/04/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 N NEEDHAM ST
-----------------------------------------------------
City | CALLAWAY
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68825-5202
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 308-836-2272
-----------------------------------------------------
Fax | 308-836-2771
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 202 S DAVIDSON ST
-----------------------------------------------------
City | CALLAWAY
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68825-2621
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-620-5204
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 89322
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------