Provider Demographics
NPI:1295551034
Name:HANSON, PATRICIA A (APRN)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:HANSON
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 N FERNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-2910
Mailing Address - Country:US
Mailing Address - Phone:321-652-6335
Mailing Address - Fax:
Practice Address - Street 1:200 S HARBOR CITY BLVD STE 401
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-1389
Practice Address - Country:US
Practice Address - Phone:321-259-1662
Practice Address - Fax:321-779-7729
Is Sole Proprietor?:No
Enumeration Date:2024-11-26
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9478580163WP0808X
FLAPRN11037220363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health