Individual
TERRIE JO HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3315 KETHLEY RD, SHAWNEE, OK 74804
(405) 878-6800
(405) 878-6831
Mailing address
PO BOX 849, SHAWNEE, OK 74802-0849
(405) 273-2576
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1497
OK
Other
Enumeration date
02/14/2006
Last updated
07/05/2018
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