Provider Demographics
NPI:1689214322
Name:HANSEN, RACHEL K (CNP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:K
Last Name:HANSEN
Suffix:
Gender:
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9323 OSUNA PL NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2278
Mailing Address - Country:US
Mailing Address - Phone:928-814-9489
Mailing Address - Fax:
Practice Address - Street 1:1298 W FINNIE FLAT RD STE 101
Practice Address - Street 2:
Practice Address - City:CAMP VERDE
Practice Address - State:AZ
Practice Address - Zip Code:86322-5958
Practice Address - Country:US
Practice Address - Phone:928-639-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-10
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM58950363LF0000X
AZ321597363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily