Individual
IAN HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1386 S 1025 W, SYRACUSE, UT 84075-9868
(801) 866-2754
Mailing address
3500 HARRISON BLVD STE 200, OGDEN, UT 84403-2038
(385) 626-6386
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
9100218-4405
UT
Other
Enumeration date
02/09/2024
Last updated
10/29/2024
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