Provider Demographics
NPI:1609615665
Name:HANSON, AMY (HEALTH COACH)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:HANSON
Suffix:
Gender:F
Credentials:HEALTH COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10340 WILLINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-6440
Mailing Address - Country:US
Mailing Address - Phone:704-582-1333
Mailing Address - Fax:
Practice Address - Street 1:10216 PERIMETER PKWY
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-2461
Practice Address - Country:US
Practice Address - Phone:704-582-1333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach