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NPI Code Detail

MEDICARE: KEITH HANSEN

MEDICARE: KEITH HANSEN
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
1163W00000XRegistered Nurse118656AK

General Provider Information

NPI Number : 1255268199
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEITH HANSEN
Provider Business Mailing Address
First Line : 2600 CORDOVA ST STE 101
Second Line :
City : ANCHORAGE
State : AK
Zip : 99503-2745
Country : US
Telephone Number : 907-279-9640
Fax Number :
Provider Business Practice Location Address
First Line : 8012 STEWART MOUNTAIN DR
Second Line :
City : EAGLE RIVER
State : AK
Zip : 99577-9013
Country : US
Telephone Number : 907-694-3336
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2026
Last Update Date : 05/05/2026

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Directions to “ KEITH HANSEN ” Practice Location

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