Basic Information
| Provider Information | |||||||||
| NPI: | 1144305129 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HANSEN | ||||||||
| FirstName: | SHARA | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13402 W COAL MINE AVE, SUITE 230 | ||||||||
| Address2: | |||||||||
| City: | LITTLETON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801275407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037302167 | ||||||||
| FaxNumber: | 3039964820 | ||||||||
| Practice Location | |||||||||
| Address1: | 13402 W COAL MINE AVE STE 230 | ||||||||
| Address2: | |||||||||
| City: | LITTLETON | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801275407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037302167 | ||||||||
| FaxNumber: | 3039964820 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2006 | ||||||||
| LastUpdateDate: | 01/12/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 123595 | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 123595 | 01 | CO | NP LICENSE | OTHER |