Individual
SUSAN AMANDA HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 E UNIVERSITY, MAGNOLIA, AR 71753-2181
(870) 235-5254
(870) 235-5254
Mailing address
100 E UNIVERSITY, SLOT 36, MAGNOLIA, AR 71753-2181
(870) 235-5254
(870) 235-5263
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R66906
AR
363LF0000X
Family Nurse Practitioner
A004721
AR
Other
Enumeration date
02/11/2011
Last updated
06/28/2016
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