Provider Demographics
NPI:1124535216
Name:HANSEN, MELISSA STARR (APRN)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:STARR
Last Name:HANSEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:STARR
Other - Last Name:HANSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:1294 S JONES BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146
Mailing Address - Country:US
Mailing Address - Phone:702-877-1877
Mailing Address - Fax:702-877-4536
Practice Address - Street 1:1294 S JONES BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146
Practice Address - Country:US
Practice Address - Phone:702-877-1877
Practice Address - Fax:702-877-4536
Is Sole Proprietor?:No
Enumeration Date:2018-01-10
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN002746363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care