MEDICARE: TRENTON JOHN HANSON APRN, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	7657194-4405	UT

General Provider Information

NPI Number	:	1013473552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRENTON JOHN HANSON APRN, FNP-C

Provider Business Mailing Address
First Line	:	4088 W 1820 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84104-4885
Country	:	US
Telephone Number	:	801-975-7799
Fax Number	:

Provider Business Practice Location Address
First Line	:	4088 W 1820 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84104-4885
Country	:	US
Telephone Number	:	801-975-7799
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2019
Last Update Date	:	07/16/2020

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