Individual
CAROLYN HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1068 E RIVERSIDE DR, ST GEORGE, UT 84790-4477
(435) 628-6466
(435) 628-3845
Mailing address
1287 SHADOW POINT DR APT 11, ST GEORGE, UT 84770-8051
(435) 680-0558
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
9413881-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9413881-4405
STATE APRN LICENSE
UT
Enumeration date
03/08/2019
Last updated
03/08/2019
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