Amber Hanson

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP1421A Issued in ID

Practice address

7600 N Mineral Dr Ste 450
Coeur D Alene, ID 83815-7709

Phone

(208) 457-4208

Fax

(208) 457-4197

NPI assigned

Feb 27, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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

• Own Family Medicine and Wellness LLC Dba Active Family Healthcare

  • Family Medicine Physician
  • Coeur d'Alene, ID
  • NPI 1942116884
  NPD (past)

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

{
    "created_epoch": "1393459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1568887503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 N MINERAL DR STE 450",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838157709",
            "telephone_number": "208-457-4208",
            "fax_number": "208-457-4198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 N MINERAL DR STE 450",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838157709",
            "telephone_number": "208-457-4208",
            "fax_number": "208-457-4197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "AMBER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-27",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP1421A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60446914",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "NP1421A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2037373",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Hansen
• Karla Leeann Hansen, ARNP
• Sheila Hansen
• Shelly Kay Hansen, LCSW
• Teresa Lynn Hansen, MA, LPC
• Carl L Hanson, MD
• Melissa Hanson, CST, CSFA
• Paige A Harder, RN /NP
• Kimberly M Hardwick, ARNP
• Cameron Kleck Hardy, DO

• Nurse Practitioner in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; 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.