Individual
ANDREW R HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8400
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
R042354
SD
367500000X
Certified Registered Nurse Anesthetist
Primary
CR001189
SD
Other
Enumeration date
05/30/2024
Last updated
07/29/2024
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