Individual
JARED CHRISTOPHER HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
420 STADIUM RD, DAYTONA BEACH, FL 32114-2400
(386) 254-1149
Mailing address
1820 LEGENDS LN APT 4202, DAYTONA BEACH, FL 32114-0008
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN11006186
FL
363LF0000X
Family Nurse Practitioner
APRN11006186
FL
Other
Enumeration date
02/17/2020
Last updated
01/08/2021
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