SUSAN JANELLE HANSON (NPI# 1114966751) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114966751 |
| Entity Type | Individual |
| Full Name | SUSAN JANELLE HANSON |
| Credential | PA-C |
| Practice Address |
1707 Gold Dr Fargo ND 58103-6413 |
| Mailing Address |
4450 31st Ave S Ste 102 Fargo ND 58104-4557 |
| Practice Telephone | 7012802033 |
| Practice Fax Number | 7012325578 |
| Mailing Telephone | 7012802033 |
| Mailing Fax Number | 7012325578 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2019-04-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PAC0312 | ND | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 11277 | 05 | |
| HEALTH PARTNERS | P50714 | 01 | |
| ND | ND BLUE SHIELD | 24823 | 01 |
| PREFERRED ONE | HN10910428 | 01 | |
| MEDICA | 01-19213 | 01 | |
| AMERICAS PPO | 2303752 | 01 | |
| ND | ND WORKERS COMP | Q25266 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922252568 | Susan D Hanson | Counselor | 405 Illinois Ave Ste 2c&d, Saint Charles, IL 60174-2963 | 2008-11-10 |
| 1508999483 | Susan Catherine Hanson | Community/Behavioral Health | Milepost 125 Tok Cut Off, Tok, AK 99780 | 2007-03-13 |
| 1538693072 | Susan Hanson | Pharmacist | 2025 Morse Ave, Sacramento, CA 95825-2115 | 2017-04-11 |
| 1821491093 | Susan K Hanson | Occupational Therapist | 1720 University Dr S, Fargo, ND 58103-4940 | 2014-10-02 |
| 1790190445 | Susan Ann Hanson | Nurse Practitioner | 801 E Orange St, Hoopeston, IL 60942-1802 | 2014-06-20 |
| 1336446202 | Susan Amanda Hanson | Registered Nurse | 100 E University, Magnolia, AR 71753-2181 | 2011-02-11 |
| 1992945752 | Susan Theresa Hanson | Counselor | 7586 Stockton Blvd, Sacramento, CA 95823-3923 | 2009-03-05 |
| 1407036858 | Susan Hanson | Counselor | 1100 Sportfisher Dr, Oceanside, CA 92054-2550 | 2007-11-13 |
| 1154548519 | Susan A Hanson | Dental Hygienist | 1115 2nd St, Fort Lupton, CO 80621-1745 | 2007-04-19 |
| 1437278926 | Susan M Hanson | Pharmacist | 56 Baribeau Dr, Brunswick, ME 04011-3251 | 2007-03-28 |
| Street Address |
1707 GOLD DR |
| City | FARGO |
| State | ND |
| Zip Code | 58103-6413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669427688 | Michael John Lillestol | Internal Medicine | 1707 Gold Dr, Ste 101, Fargo, ND 58103-6413 | 2006-05-25 |
| 1518901172 | Rodney A Ludwig | Internal Medicine | 1707 Gold Dr, Fargo, ND 58103-6413 | 2006-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659924843 | Amanda Hericks | Dentist | 1338 Gateway Drive S, Fargo, ND 58103 | 2019-07-17 |
| 1285298240 | Ann Louise Breen | Optometrist | Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 | 2019-04-25 |
| 1245706597 | Lisa Elaine Livingston | Counselor | 1337 14 and Half St. S., Fargo, ND 58103 | 2018-10-15 |
| 1528569662 | Misty Lynn Hagen | Counselor | 901 28th St. South, Suite B, Fargo, ND 58103 | 2018-02-23 |
| 1083133011 | Faith Homecare Professionals LLC | Home Health | 304 25th St S, Suite B, Fargo, ND 58103 | 2017-09-11 |
| 1982138749 | Matthew Troyer | Pharmacist | 2425 13th Ave, Fargo, ND 58103 | 2017-04-18 |
| 1801338504 | Amy Nguyen Christianson | Chiropractor | 1650 45th St S Ste 113, Fargo, ND 58103 | 2016-11-11 |
| 1245772359 | Andrea Marie Hanson | Nurse Practitioner | 2400 32nd Ave South, Fargo, ND 58103 | 2016-11-07 |
| 1831647940 | Abigail Carmen Burkett Vetter | Nurse Practitioner | 2928 University Dr S Suite 101, Fargo, ND 58103 | 2016-09-18 |
| 1013361302 | Nancy Knowlton | Speech-Language Pathologist | 3001 11th Ave S, Beyond Boundaries Speech-language, Fargo, ND 58103 | 2016-04-22 |
| Find all providers in zip 58103 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205015633 | Jamie M Brown | Physician Assistant | 1711 Gold Dr S, Suite 170, Fargo, ND 58103-6416 | 2007-11-02 |
| 1790703353 | Mary Jane Kadry | Physician Assistant | 1121 Westrac Dr S Ste 204, Fargo, ND 58103-2385 | 2006-07-18 |
| 1861419723 | Catherine M Garvey | Physician Assistant | 2801 University Dr S, Fargo, ND 58103-6029 | 2006-07-16 |
| 1881148005 | Kali Luecke | Physician Assistant | 301 Np Ave N, Fargo, ND 58102-4835 | 2016-08-04 |
| 1215480009 | Jason Byrne Smith | Physician Assistant | 801 Broadway N, Fargo, ND 58102-3641 | 2016-07-27 |
| 1659758381 | Sarah Winter | Physician Assistant | 1702 University Dr S, Fargo, ND 58103-4940 | 2015-05-01 |
| 1861801763 | Lisa Lynn Froemke | Physician Assistant | 3838 12th Ave N, Fargo, ND 58102-2931 | 2014-08-05 |
| 1033525365 | Kathryn Gray | Physician Assistant | 301 Np Ave N, Fargo, ND 58102-4835 | 2014-07-08 |
| 1326462490 | Shannon Lynn Gullingsrud | Physician Assistant | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2014-02-10 |
| 1467722702 | Yan Tesch | Physician Assistant | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2012-01-04 |
| Find all providers in FARGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.