Individual
JANIS HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
10 S 2000 E, SALT LAKE CITY, UT 84112-5880
(801) 581-8261
Mailing address
2839 E OAKHURST DR, SALT LAKE CITY, UT 84108-2029
(608) 509-3461
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
6209243-4405
UT
363LF0000X
Family Nurse Practitioner
6209243-4405
UT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
6209243-4405
UT
Other
Enumeration date
02/12/2019
Last updated
03/24/2021
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