Provider Demographics
NPI:1760534598
Name:HANSON, LOUISE O (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:LOUISE
Middle Name:O
Last Name:HANSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:LOUISE
Other - Middle Name:D
Other - Last Name:O'CONNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2002 MEDICAL PKWY
Mailing Address - Street 2:520
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3046
Mailing Address - Country:US
Mailing Address - Phone:410-573-8430
Mailing Address - Fax:410-573-5981
Practice Address - Street 1:2002 MEDICAL PKWY
Practice Address - Street 2:520
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3046
Practice Address - Country:US
Practice Address - Phone:410-573-8430
Practice Address - Fax:410-573-5981
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0363195363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC409629OtherMEDICARE GROUP
MD066MOtherMEDICARE GROUP
MDCD0361OtherRAILROAD MEDICARE GROUP
MDQ09606Medicare UPIN
DC409629OtherMEDICARE GROUP