Provider Demographics
NPI:1578274080
Name:HANSEN, KARLA LEEANN (ARNP)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:LEEANN
Last Name:HANSEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 S NEWER RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99037-9731
Mailing Address - Country:US
Mailing Address - Phone:509-710-0990
Mailing Address - Fax:
Practice Address - Street 1:2199 N MERRIT CRK LOOP
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-4949
Practice Address - Country:US
Practice Address - Phone:208-665-7546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID67775163W00000X, 363L00000X
WARN60717435163W00000X
WAAP61348708363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse