Provider Demographics
NPI:1942549290
Name:HANSON, KYRA (MSN, NP)
Entity Type:Individual
Prefix:
First Name:KYRA
Middle Name:
Last Name:HANSON
Suffix:
Gender:F
Credentials:MSN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:854 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94133-2619
Mailing Address - Country:US
Mailing Address - Phone:415-577-2297
Mailing Address - Fax:
Practice Address - Street 1:1720 EL CAMINO REAL STE 130
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3226
Practice Address - Country:US
Practice Address - Phone:650-692-0977
Practice Address - Fax:650-259-5840
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-06
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA790858163W00000X
CA22766363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse