Provider Demographics
NPI:1992769210
Name:HANSEN, ALISON J (APN)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:J
Last Name:HANSEN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:J
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:1155 MILL ST # M14
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1576
Mailing Address - Country:US
Mailing Address - Phone:775-982-5262
Mailing Address - Fax:775-789-9208
Practice Address - Street 1:1500 E 2ND ST STE 300
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1198
Practice Address - Country:US
Practice Address - Phone:775-982-5000
Practice Address - Fax:775-982-3900
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN000737363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV000777OtherAPRN LIC
NV11832599OtherCAQH NUMBER
NV100508350Medicaid
100784Medicare ID - Type Unspecified
NVV100784OtherPTAN
NV100508350Medicaid