Provider Demographics
NPI:1699898239
Name:HANSON, LACINDA KAY (RNFA)
Entity type:Individual
Prefix:
First Name:LACINDA
Middle Name:KAY
Last Name:HANSON
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 WESTOWN PKWY
Mailing Address - Street 2:SUITE 240
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8218
Mailing Address - Country:US
Mailing Address - Phone:515-267-8300
Mailing Address - Fax:515-267-8872
Practice Address - Street 1:5901 WESTOWN PKWY
Practice Address - Street 2:SUITE 240
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8218
Practice Address - Country:US
Practice Address - Phone:515-267-8300
Practice Address - Fax:515-267-8872
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA088320163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant