Individual
TERRA HANSEN SHARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
111 11TH ST UNIT 102, STEAMBOAT SPRINGS, CO 80487
(970) 879-2212
Mailing address
701 SAN MATEO BLVD NE, ALBUQUERQUE, NM 87108-1434
(505) 265-9511
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN.1629294
CO
363L00000X
Nurse Practitioner
APN0994880NP
CO
363LF0000X
Family Nurse Practitioner
Primary
APN.0994880-NP
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000177803
—
CO
Enumeration date
11/24/2014
Last updated
08/03/2021
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