Provider Demographics
NPI:1841515988
Name:HANSEN, MAUREEN K (LPN)
Entity type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:K
Last Name:HANSEN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:KOSTUN
Other - Last Name:HANSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:109 MOHAWK AVE.
Mailing Address - Street 2:GENTLE HOME HEALTH CARE, INC.
Mailing Address - City:SCOTIA
Mailing Address - State:NY
Mailing Address - Zip Code:12302
Mailing Address - Country:US
Mailing Address - Phone:518-370-1515
Mailing Address - Fax:
Practice Address - Street 1:109 MOHAWK AVE.
Practice Address - Street 2:GENTLE HOME HEALTH CARE, INC.
Practice Address - City:SCOTIA
Practice Address - State:NY
Practice Address - Zip Code:12302
Practice Address - Country:US
Practice Address - Phone:518-370-1515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192049-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse