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NPI Code Detail

MEDICARE: KRISTIN L HANSON M.D.

MEDICARE: KRISTIN L HANSON M.D.
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
1207RE0101XEndocrinology, Diabetes & Metabolism Physician21926AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
121926OTHERAZMEDICAL LICENSE

General Provider Information

NPI Number : 1659379378
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN L HANSON M.D.
Provider Business Mailing Address
First Line : 15640 N 28TH DR
Second Line :
City : PHOENIX
State : AZ
Zip : 85053-4059
Country : US
Telephone Number : 602-439-9000
Fax Number : 602-978-5233
Provider Business Practice Location Address
First Line : 15640 N 28TH DR
Second Line :
City : PHOENIX
State : AZ
Zip : 85053-4059
Country : US
Telephone Number : 602-439-9000
Fax Number : 602-978-5233
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 08/15/2024

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Directions to “ KRISTIN L HANSON M.D.” Practice Location

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