Provider Demographics
NPI:1417753047
Name:HANSEN, KRIS
Entity type:Individual
Prefix:
First Name:KRIS
Middle Name:
Last Name:HANSEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2294 S 1570 EAST CIR
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-8685
Mailing Address - Country:US
Mailing Address - Phone:435-313-5427
Mailing Address - Fax:435-213-2691
Practice Address - Street 1:352 E RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-6758
Practice Address - Country:US
Practice Address - Phone:435-579-3494
Practice Address - Fax:435-213-2691
Is Sole Proprietor?:No
Enumeration Date:2025-02-24
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13957750-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist