Provider Demographics
NPI:1881873396
Name:HANSEN, LAUREN RUTH (PT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:RUTH
Last Name:HANSEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:LAUREN
Other - Middle Name:RUTH
Other - Last Name:HANSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1184 SHEFFIELD PL
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2017
Mailing Address - Country:US
Mailing Address - Phone:859-321-0829
Mailing Address - Fax:
Practice Address - Street 1:1184 SHEFFIELD PL
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2017
Practice Address - Country:US
Practice Address - Phone:859-321-0829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004392174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist