Provider Demographics
NPI:1174860233
Name:HANSEN, ANNE LUSIGNAN (RN)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:LUSIGNAN
Last Name:HANSEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2951 NW HAYES AVE
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-1855
Mailing Address - Country:US
Mailing Address - Phone:541-740-4871
Mailing Address - Fax:
Practice Address - Street 1:2951 NW HAYES AVE
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-1855
Practice Address - Country:US
Practice Address - Phone:541-740-4871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201242911RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse