Provider Demographics
NPI:1699748723
Name:HANSEN, JOY U (OD)
Entity type:Individual
Prefix:DR
First Name:JOY
Middle Name:U
Last Name:HANSEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:L
Other - Last Name:UTTERBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1371 HECLA DR
Mailing Address - Street 2:STE C
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-2318
Mailing Address - Country:US
Mailing Address - Phone:303-666-7226
Mailing Address - Fax:303-665-3367
Practice Address - Street 1:4 GARDEN CENTER
Practice Address - Street 2:STE 100
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-7090
Practice Address - Country:US
Practice Address - Phone:303-469-1941
Practice Address - Fax:303-469-6634
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2305152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COU93631Medicare UPIN
CO484328Medicare ID - Type Unspecified