Provider Demographics
NPI:1427116052
Name:HANSON, BLAINETTE U (MPH,MSN,APRN-C)
Entity type:Individual
Prefix:MRS
First Name:BLAINETTE
Middle Name:U
Last Name:HANSON
Suffix:
Gender:F
Credentials:MPH,MSN,APRN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6689 NEW RD
Mailing Address - Street 2:
Mailing Address - City:HAHIRA
Mailing Address - State:GA
Mailing Address - Zip Code:31632-4311
Mailing Address - Country:US
Mailing Address - Phone:229-794-3196
Mailing Address - Fax:229-794-3928
Practice Address - Street 1:185 N. BAKER ST.
Practice Address - Street 2:
Practice Address - City:ELLENTON
Practice Address - State:GA
Practice Address - Zip Code:31747
Practice Address - Country:US
Practice Address - Phone:229-324-2845
Practice Address - Fax:229-324-3383
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN096693363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily