Individual
MRS. KELLY RAE HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
500 HIGHWAY 89 NORTH, PRESCOTT, AZ 86313-5001
(928) 445-4860
Mailing address
62 WOODSIDE DR, PRESCOTT, AZ 86305-5090
(928) 432-5111
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
295242
AZ
Other
Enumeration date
08/07/2023
Last updated
08/07/2023
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