Maren Hansen, ATC-L
Individual provider Active NPI Athletic Trainer · West Bountiful, UT
NPI 1851473383 · NPPES record last updated Jan 2, 2009
Key facts
- NPI
- 1851473383
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 1385197-4810 (UT)
- Practice address
- 875 Summer Tree Dr
West Bountiful, UT 84087-1955 - Phone
- (801) 296-1139
- NPI assigned
- Oct 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1385197-4810 | UT | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 1385197-4810 | UT | Yes |
Addresses
Primary practice location
875 Summer Tree Dr
West Bountiful, UT 84087-1955
Mailing address
875 Summer Tree Dr
West Bountiful, UT 84087-1955
Phone (801) 296-1139
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All providers in West Bountiful, UT · Athletic Trainer in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 2, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.