Provider Demographics
NPI:1366818072
Name:HANSON, MARY (CNP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:HANSON
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2951 MAPLE AVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1406
Mailing Address - Country:US
Mailing Address - Phone:740-454-5000
Mailing Address - Fax:740-455-7580
Practice Address - Street 1:2951 MAPLE AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1406
Practice Address - Country:US
Practice Address - Phone:740-454-5000
Practice Address - Fax:740-455-7580
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-17
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH18298363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily