Provider Demographics
NPI:1023629698
Name:CANN-HANSON, FELICIA (PROSTHETIC SPECIALIS)
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:CANN-HANSON
Suffix:
Gender:F
Credentials:PROSTHETIC SPECIALIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7407 MANCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63143-3031
Mailing Address - Country:US
Mailing Address - Phone:314-449-1115
Mailing Address - Fax:
Practice Address - Street 1:7407 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63143-3031
Practice Address - Country:US
Practice Address - Phone:314-449-1115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-16
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management