Provider Demographics
NPI:1962732917
Name:HANSON, ERIC LOUIS (RN,)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:LOUIS
Last Name:HANSON
Suffix:
Gender:M
Credentials:RN,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2036 COURTYARD LOOP APT 100
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-7457
Mailing Address - Country:US
Mailing Address - Phone:407-435-6812
Mailing Address - Fax:
Practice Address - Street 1:2036 COURTYARD LOOP APT 100
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-7457
Practice Address - Country:US
Practice Address - Phone:407-435-6812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2964182163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health