1760534598 NPI number — MRS. LOUISE O HANSON CRNP

Table of content: MRS. LOUISE O HANSON CRNP (NPI 1760534598)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760534598 NPI number — MRS. LOUISE O HANSON CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HANSON
Provider First Name:
LOUISE
Provider Middle Name:
O
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
O'CONNER
Provider Other First Name:
LOUISE
Provider Other Middle Name:
D
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1760534598
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/24/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2002 MEDICAL PKWY
Provider Second Line Business Mailing Address:
520
Provider Business Mailing Address City Name:
ANNAPOLIS
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21401-3046
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-573-8430
Provider Business Mailing Address Fax Number:
410-573-5981

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2002 MEDICAL PKWY
Provider Second Line Business Practice Location Address:
520
Provider Business Practice Location Address City Name:
ANNAPOLIS
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21401-3046
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-573-8430
Provider Business Practice Location Address Fax Number:
410-573-5981
Provider Enumeration Date:
01/18/2007

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: 363LA2100X , with the licence number:  0363195 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 409629 . This is a "MEDICARE GROUP" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 066M . This is a "MEDICARE GROUP" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: CD0361 . This is a "RAILROAD MEDICARE GROUP" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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