Provider Demographics
NPI:1023476272
Name:HANSON, KARLA JOANN (AGACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:JOANN
Last Name:HANSON
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 E US 6 FRONTAGE RD
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:AZ
Mailing Address - Zip Code:46383
Mailing Address - Country:US
Mailing Address - Phone:219-983-8300
Mailing Address - Fax:
Practice Address - Street 1:2000 ROOSEVELT RD BLDG A
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-2800
Practice Address - Country:US
Practice Address - Phone:219-263-7240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-03
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71007069A363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care