Individual
LORI L HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2829 VIRGINIA AVE, NARROWS, VA 24124-2369
(540) 726-7900
Mailing address
388 HORSESHOE FARM RD, PEMBROKE, VA 24136-3478
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101-229022
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005646901
—
VA
05
—
005646910
—
VA
Enumeration date
11/22/2005
Last updated
10/28/2008
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