Individual
JONATHAN DAVID HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1707 W CHARLESTON BLVD STE 100, LAS VEGAS, NV 89102-2352
(702) 676-3650
(702) 671-5198
Mailing address
3016 W CHARLESTON BLVD STE 100, LAS VEGAS, NV 89102-1973
(702) 780-2315
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO3871
NV
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/28/2022
Last updated
08/18/2025
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