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NPI Code Detail

MEDICARE: DR. BLAKE HANSEN DNP, FNP-C

MEDICARE: DR. BLAKE HANSEN DNP, 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
1363LF0000XFamily Nurse Practitioner71013978AIN

General Provider Information

NPI Number : 1962195016
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BLAKE HANSEN DNP, FNP-C
Provider Business Mailing Address
First Line : 2801 BERTHOLET BLVD STE 201
Second Line :
City : VALPARAISO
State : IN
Zip : 46383-7959
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2801 BERTHOLET BLVD STE 201
Second Line :
City : VALPARAISO
State : IN
Zip : 46383-7959
Country : US
Telephone Number : 844-458-2800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2023
Last Update Date : 02/04/2026

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