1689793663 NPI number — MRS. ERIN M FITZPATRICK HANSON NP

Table of content: MRS. ERIN M FITZPATRICK HANSON NP (NPI 1689793663)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689793663 NPI number — MRS. ERIN M FITZPATRICK HANSON NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HANSON
Provider First Name:
ERIN
Provider Middle Name:
M FITZPATRICK
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FITZPATRICK
Provider Other First Name:
ERIN
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1689793663
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/31/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 HOUGHTON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAGINAW
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48602-5303
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-583-6800
Provider Business Mailing Address Fax Number:
989-583-6915

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1575 CONCENTRIC BLVD
Provider Second Line Business Practice Location Address:
STE. 1
Provider Business Practice Location Address City Name:
SAGINAW
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48604-9312
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-583-6800
Provider Business Practice Location Address Fax Number:
989-583-6915
Provider Enumeration Date:
03/28/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0200X , with the licence number:  4704206715 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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