Provider Demographics
NPI:1336408434
Name:HANSEN, PATRICIA J (RN)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:J
Last Name:HANSEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:PATRICIA
Other - Middle Name:J
Other - Last Name:LOERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1200 1ST AVE E
Mailing Address - Street 2:STE C
Mailing Address - City:SPENCER
Mailing Address - State:IA
Mailing Address - Zip Code:51301-4342
Mailing Address - Country:US
Mailing Address - Phone:712-262-7511
Mailing Address - Fax:712-262-3658
Practice Address - Street 1:1200 1ST AVE E
Practice Address - Street 2:STE C
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-4342
Practice Address - Country:US
Practice Address - Phone:712-262-7511
Practice Address - Fax:712-262-3658
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA054926163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse