Provider Demographics
NPI:1407512601
Name:HANSEN, DANIELLE N (PMHNP)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:N
Last Name:HANSEN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 E SOUTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-5612
Mailing Address - Country:US
Mailing Address - Phone:602-848-4312
Mailing Address - Fax:
Practice Address - Street 1:1440 E SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-5612
Practice Address - Country:US
Practice Address - Phone:602-848-4312
Practice Address - Fax:602-932-5846
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2024-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ266575363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health