Provider Demographics
NPI:1396482758
Name:HANSEN, CHERYL L (RNMS)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:L
Last Name:HANSEN
Suffix:
Gender:F
Credentials:RNMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 VINCENT DR
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-3317
Mailing Address - Country:US
Mailing Address - Phone:315-836-5619
Mailing Address - Fax:
Practice Address - Street 1:5 VINCENT DR
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-3317
Practice Address - Country:US
Practice Address - Phone:315-836-5619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY446829163WH0200X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health