Provider Demographics
NPI:1871601922
Name:HANSEN, LAURA KATHYRN (MSN, PNP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:KATHYRN
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MSN, PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1916 PATTERSON ST
Mailing Address - Street 2:SUITE 405
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2120
Mailing Address - Country:US
Mailing Address - Phone:615-329-9888
Mailing Address - Fax:615-329-2345
Practice Address - Street 1:1916 PATTERSON ST
Practice Address - Street 2:SUITE 405
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2120
Practice Address - Country:US
Practice Address - Phone:615-329-9888
Practice Address - Fax:615-329-2345
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000008300363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4064521OtherBCBS