Provider Demographics
NPI:1811663651
Name:HANSON, AMBER RACHELLE (PMHNP)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:RACHELLE
Last Name:HANSON
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 NORTH 34TH STREET
Mailing Address - Street 2:POB 2315
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68702
Mailing Address - Country:US
Mailing Address - Phone:402-371-3044
Mailing Address - Fax:402-371-9643
Practice Address - Street 1:200 N 34TH ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-3197
Practice Address - Country:US
Practice Address - Phone:402-371-3044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE113764363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health