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General NPI Number Information
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NPI Number | 1992894018
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Entity Type | Individual
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Provider Name | RUTH ELLEN HANSON MSN, RN, IBCLC
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Gender | Female
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 07/09/2024
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Provider Practice Location Address
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Address Line | 99TH MDG HCOS, SGOC-PEDIATRIC CLINIC 4700 LAS VEGAS BLVD. N.
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City | NELLIS AFB
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State | NV
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Zip | 89191
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Country | US
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Telephone | 702-653-3504
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Fax |
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Provider Business Mailing Address
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Address Line | 99TH MDG HCOS, SGOC-PEDIATRIC CLINIC 4700 LAS VEGAS BLVD. N.
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City | NELLIS AFB
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State | NV
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Zip | 89191
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Country | US
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Telephone | 702-653-3504
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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 | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | 13-41410-092
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License Number State | KS
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