Provider Demographics
NPI:1821407347
Name:HANSEN, GINA COTTON (NP)
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:COTTON
Last Name:HANSEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:GINA
Other - Middle Name:MARIE
Other - Last Name:COTTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:401 15TH AVE S STE 205
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-4334
Mailing Address - Country:US
Mailing Address - Phone:406-866-0280
Mailing Address - Fax:406-866-0270
Practice Address - Street 1:401 15TH AVE S STE 205
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4334
Practice Address - Country:US
Practice Address - Phone:406-866-0280
Practice Address - Fax:406-866-0270
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-08
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT29357363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner