Provider Demographics
NPI:1598354805
Name:HANSEN, RACHELL DANETTE (APRN)
Entity Type:Individual
Prefix:MS
First Name:RACHELL
Middle Name:DANETTE
Last Name:HANSEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 BROOKSTONE DR
Mailing Address - Street 2:
Mailing Address - City:WALTON
Mailing Address - State:KY
Mailing Address - Zip Code:41094-8273
Mailing Address - Country:US
Mailing Address - Phone:859-485-7319
Mailing Address - Fax:
Practice Address - Street 1:236 WENDEL H FORD BLVD
Practice Address - Street 2:
Practice Address - City:ERLANGER
Practice Address - State:KY
Practice Address - Zip Code:41018-1272
Practice Address - Country:US
Practice Address - Phone:800-225-5345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3011908363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health