Individual provider Active NPI

Ruth Ellen Hanson, MSN, RN, IBCLC

  • Lactation Consultant (Registered Nurse)
  • Nellis Afb, NV
National Provider Identifier
1992894018
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
13-41410-092 Issued in KS
Practice address
99TH MDG Hcos, Sgoc-Pediatric Clinic
4700 Las Vegas Blvd. N.
Nellis Afb, NV 89191
Phone
(702) 653-3504
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X 13-41410-092 KS Primary

Addresses

Primary practice location

99TH MDG Hcos, Sgoc-Pediatric Clinic
4700 Las Vegas Blvd. N.
Nellis Afb, NV 89191

Mailing address

99TH MDG Hcos, Sgoc-Pediatric Clinic
4700 Las Vegas Blvd. N.
Nellis Afb, NV 89191
Phone (702) 653-3504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
13-41410-092KSMDLactation Consultant (Registered Nurse)

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1992894018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99TH MDG HCOS, SGOC-PEDIATRIC CLINIC",
            "address_2": "4700 LAS VEGAS BLVD. N.",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "89191",
            "telephone_number": "702-653-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99TH MDG HCOS, SGOC-PEDIATRIC CLINIC",
            "address_2": "4700 LAS VEGAS BLVD. N.",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "89191",
            "telephone_number": "702-653-3504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "RUTH",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "MSN, RN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "KS",
            "license": "13-41410-092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nellis Afb, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.