Provider Demographics
NPI:1780725226
Name:HANSON, SHARON A (NP)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:A
Last Name:HANSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 324
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER MILLS
Mailing Address - State:CA
Mailing Address - Zip Code:96028-0324
Mailing Address - Country:US
Mailing Address - Phone:530-526-3531
Mailing Address - Fax:
Practice Address - Street 1:554 850 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:BIEBER
Practice Address - State:CA
Practice Address - Zip Code:96009-0000
Practice Address - Country:US
Practice Address - Phone:530-294-5241
Practice Address - Fax:530-294-5392
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP-16178363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA16178OtherNURSE PRACTITIONER