Individual provider Active NPI

Andrea Jean Hanson, FNP

  • Family Nurse Practitioner
  • Sandstone, MN
National Provider Identifier
1245062546
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11972 Issued in MN
Practice address
501 Main St
Sandstone, MN 55072-4410
Phone
(320) 372-2323
NPI assigned
Aug 15, 2024
Last updated
Aug 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11972 MN Primary

Addresses

Primary practice location

501 Main St
Sandstone, MN 55072-4410

Mailing address

501 Main St
Sandstone, MN 55072-4410
Phone (320) 372-2323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241004003282 MN Practitioner - Nurse Practitioner 2163953852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Selah Wellness Clinic LLCGroup PAC ID 5597146852, 8 clinicians

Practice addresses (Care Compare)

501 Main St
Sandstone, MN 55072-4410
Phone (320) 372-2323

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Selah Wellness Clinic LLC CurrentSince Sep 16, 2024 Accepting new patients
Selah Wellness Clinic LLC CurrentSince Sep 16, 2024 Accepting new patients
Selah Wellness Clinic LLC Past Accepting new patients

Locations

1300 Northridge Ct NW
Pine City, MN 55063
Phone (320) 372-2312

1300 Northridge Ct NW
Ste 2
Pine City, MN 55063
Phone (320) 372-2312

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1245062546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 MAIN ST",
            "city": "SANDSTONE",
            "state": "MN",
            "postal_code": "550724410",
            "telephone_number": "320-372-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 MAIN ST",
            "city": "SANDSTONE",
            "state": "MN",
            "postal_code": "550724410",
            "telephone_number": "320-372-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "ANDREA",
        "middle_name": "JEAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "11972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandstone, MN

Sources for this page

Verify at the official NPI Registry.