Provider Demographics
NPI:1306052279
Name:HANSON, VICKY WHITTINGTON (ANP- BC)
Entity type:Individual
Prefix:MS
First Name:VICKY
Middle Name:WHITTINGTON
Last Name:HANSON
Suffix:
Gender:F
Credentials:ANP- BC
Other - Prefix:
Other - First Name:VICKY
Other - Middle Name:WHITTINGTON
Other - Last Name:ALDAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3025 SHRINE RD
Mailing Address - Street 2:STE 270
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520
Mailing Address - Country:US
Mailing Address - Phone:912-262-2723
Mailing Address - Fax:877-244-5666
Practice Address - Street 1:3025 SHRINE RD
Practice Address - Street 2:STE 270
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520
Practice Address - Country:US
Practice Address - Phone:912-262-2723
Practice Address - Fax:877-244-5666
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN061053363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health