Individual
LISA MARIE HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4538 W SOUTH JORDAN PKWY UNIT 110, SOUTH JORDAN, UT 84009-5852
(801) 661-6052
Mailing address
4538 W SOUTH JORDAN PKWY UNIT 110, SOUTH JORDAN, UT 84009-5852
(801) 661-6052
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
5984518-4405
UT
Other
Enumeration date
09/29/2022
Last updated
09/29/2022
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