Provider Demographics
NPI:1710024963
Name:HANSEN, CARRIE SUE (NP)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:SUE
Last Name:HANSEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03743-2636
Mailing Address - Country:US
Mailing Address - Phone:603-542-6455
Mailing Address - Fax:603-543-0736
Practice Address - Street 1:252 BROAD ST
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:NH
Practice Address - Zip Code:03743-2636
Practice Address - Country:US
Practice Address - Phone:603-542-6455
Practice Address - Fax:603-543-0736
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2260002363LF0000X
NH091939-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily