Provider Demographics
NPI:1780564112
Name:DIRECT ACCESS PRIMARY CARE
Entity type:Organization
Organization Name:DIRECT ACCESS PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNP/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MSN, RN, CNP, WCC
Authorized Official - Phone:513-951-3055
Mailing Address - Street 1:431 OHIO PIKE STE 223
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-3720
Mailing Address - Country:US
Mailing Address - Phone:513-951-3077
Mailing Address - Fax:
Practice Address - Street 1:431 OHIO PIKE STE 223
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-3720
Practice Address - Country:US
Practice Address - Phone:513-951-3077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty