Mark Duane Hansen, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

747144 Issued in CA

Practice address

20070 Audrey LN
Prunedale, CA 93907-8407

Phone

(801) 381-1719

NPI assigned

Sep 10, 2013

Last updated

Sep 10, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1378771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378771200000",
    "number": "1063847077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20070 AUDREY LN",
            "city": "PRUNEDALE",
            "state": "CA",
            "postal_code": "939078407",
            "telephone_number": "801-381-1719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20070 AUDREY LN",
            "city": "PRUNEDALE",
            "state": "CA",
            "postal_code": "939078407",
            "telephone_number": "801-381-1719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "MARK",
        "middle_name": "DUANE",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-10",
        "last_updated": "2013-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "747144",
            "primary": true
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "CA",
            "license": "747144",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Cobb-Jarschke, RN
• County of Monterey
• Bridget Monica Eastman
• Cheryl Diane Fernandez, MFT
• Cherisse R Gage, MA, LPCC, LMFT
• Alim Alusine Ibrahim, PA-C
• Alexander Albert Jaque
• Lucas Jared Johnson, M.P.T
• Mark Juarez, PHARM.D.
• Briana Lawson, PT, DPT

• Registered Nurse in Prunedale, CA
• Providers in Prunedale, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.