Provider Demographics
NPI:1063420867
Name:HANSON, GREER W (ARNP)
Entity type:Individual
Prefix:
First Name:GREER
Middle Name:W
Last Name:HANSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 36TH ST
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4862
Mailing Address - Country:US
Mailing Address - Phone:772-567-4311
Mailing Address - Fax:
Practice Address - Street 1:1040 37TH PL
Practice Address - Street 2:SUITE 101
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4806
Practice Address - Country:US
Practice Address - Phone:772-563-4580
Practice Address - Fax:772-563-4690
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9189717363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY100WOtherBLUE CROSS
FLY100WOtherBLUE CROSS
FLP41457Medicare UPIN
FLU7053YMedicare PIN