Individual
JAIME HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C, FNP-BC
Contact information
Practice address
671 SW MAIN ST, WINSTON, OR 97496-6571
(541) 672-2691
Mailing address
PO BOX 1121, ROSEBURG, OR 97470-0254
(801) 707-3755
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
202108779NP-PP
OR
363LF0000X
Family Nurse Practitioner
7197553-4405
UT
Other
Enumeration date
06/22/2021
Last updated
04/27/2023
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