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NPI Code Detail

MEDICARE: SARAH ELLEN HANSEN

MEDICARE: SARAH ELLEN 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
1363LF0000XFamily Nurse PractitionerR34051ND

General Provider Information

NPI Number : 1619697521
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH ELLEN HANSEN
Provider Business Mailing Address
First Line : 11682 35M ST SE
Second Line :
City : VALLEY CITY
State : ND
Zip : 58072-9522
Country : US
Telephone Number : 701-840-0706
Fax Number :
Provider Business Practice Location Address
First Line : 132 4TH AVE NE
Second Line :
City : VALLEY CITY
State : ND
Zip : 58072-3056
Country : US
Telephone Number : 701-845-8060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2022
Last Update Date : 08/31/2022

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