Provider Demographics
NPI:1326001926
Name:HANSON, NICHOLE A (RN, MSN, NNP)
Entity Type:Individual
Prefix:MRS
First Name:NICHOLE
Middle Name:A
Last Name:HANSON
Suffix:
Gender:F
Credentials:RN, MSN, NNP
Other - Prefix:
Other - First Name:NICHOLE
Other - Middle Name:A
Other - Last Name:ZWENGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1897
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-1897
Mailing Address - Country:US
Mailing Address - Phone:316-268-8131
Mailing Address - Fax:316-291-4788
Practice Address - Street 1:3600 E HARRY ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-3713
Practice Address - Country:US
Practice Address - Phone:316-689-5475
Practice Address - Fax:316-691-6772
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-45854363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200376330AMedicaid