Provider Demographics
NPI:1306870803
Name:HANSON, JOAN MARIE (NP)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:MARIE
Last Name:HANSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - Street 2:420 DELAWARE STREET SE, MMC 395
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454
Mailing Address - Country:US
Mailing Address - Phone:612-626-3111
Mailing Address - Fax:612-626-0665
Practice Address - Street 1:UNIVERSITY OF MINNESOTA PHYSICIANS
Practice Address - Street 2:606 24TH AVENUE SOUTH, SUITE 500
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454
Practice Address - Country:US
Practice Address - Phone:612-627-4564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 119637-9363L00000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Not Answered363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1012602OtherPREFERRED ONE
MN07-04576OtherMEDICA CHOICE
MN101673OtherUCARE
MN64G28HAOtherBCBS
MN855179OtherARAZ
WI43971200Medicaid
MNHP19407OtherHEALTHPARTNERS
MN07-03932OtherMEDICA PRIMARY
MN101673OtherUCARE