Provider Demographics
NPI:1467945840
Name:HANSON, BRANDY LYNN (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:LYNN
Last Name:HANSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7929 S YATES BLVD
Mailing Address - Street 2:STE 201
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617-1102
Mailing Address - Country:US
Mailing Address - Phone:773-966-4569
Mailing Address - Fax:773-868-6828
Practice Address - Street 1:7929 S YATES BLVD
Practice Address - Street 2:STE 201
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-1102
Practice Address - Country:US
Practice Address - Phone:773-868-6824
Practice Address - Fax:773-868-6828
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-11
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209017179363LF0000X
IL277001316363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty