Provider Demographics
NPI:1578508305
Name:HANSETT, FLOYD (BC-HIS, ACA)
Entity Type:Individual
Prefix:
First Name:FLOYD
Middle Name:
Last Name:HANSETT
Suffix:
Gender:M
Credentials:BC-HIS, ACA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2757B S CLARK ST
Mailing Address - Street 2:
Mailing Address - City:MEXICO
Mailing Address - State:MO
Mailing Address - Zip Code:65265-3720
Mailing Address - Country:US
Mailing Address - Phone:573-581-6633
Mailing Address - Fax:573-581-9998
Practice Address - Street 1:2757B S CLARK ST
Practice Address - Street 2:
Practice Address - City:MEXICO
Practice Address - State:MO
Practice Address - Zip Code:65265-3720
Practice Address - Country:US
Practice Address - Phone:573-581-6633
Practice Address - Fax:573-581-9998
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO001294237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist