Provider Demographics
NPI:1295006401
Name:HANSEN, ASHLEY SUZANNE (APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:SUZANNE
Last Name:HANSEN
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12093 MOSEY LN
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-6318
Mailing Address - Country:US
Mailing Address - Phone:307-431-2245
Mailing Address - Fax:
Practice Address - Street 1:2525 CHARLESTON RD STE 104
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043-1636
Practice Address - Country:US
Practice Address - Phone:307-431-2245
Practice Address - Fax:303-649-3101
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-19
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8078429-4405363LF0000X
AL3-000982363LF0000X
COAPN.0991222-NP363LP2300X
CA95023606363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOA108830OtherMEDICARE
CO64155854Medicaid