Provider Demographics
NPI:1447332242
Name:HANSEN, CHRISTOPHER NORMAN PIERCE (OD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:NORMAN PIERCE
Last Name:HANSEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 WENONAH AVE
Mailing Address - Street 2:700 WENONAH AVE
Mailing Address - City:PEARISBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24134-1638
Mailing Address - Country:US
Mailing Address - Phone:540-921-4116
Mailing Address - Fax:540-921-4118
Practice Address - Street 1:324 OAKVALE RD STE 100
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-3829
Practice Address - Country:US
Practice Address - Phone:304-425-2444
Practice Address - Fax:304-425-2446
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV973-OD152W00000X
VA0618000990152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
810833OtherEYEMED VISION
VA010076404Medicaid
U83976Medicare UPIN
00W943C01Medicare ID - Type Unspecified