Provider Demographics
NPI:1255082434
Name:HANSON, SHAWNA MARIE (DNP, APRN, CNP)
Entity type:Individual
Prefix:MRS
First Name:SHAWNA
Middle Name:MARIE
Last Name:HANSON
Suffix:
Gender:F
Credentials:DNP, APRN, CNP
Other - Prefix:MISS
Other - First Name:SHAWNA
Other - Middle Name:MARIE
Other - Last Name:ELLEFSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7508 SAFARI CT NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-8843
Mailing Address - Country:US
Mailing Address - Phone:507-358-4815
Mailing Address - Fax:
Practice Address - Street 1:210 9TH ST SE STE 1
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-6400
Practice Address - Country:US
Practice Address - Phone:507-288-3443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8491363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily