Hansen, Jeffrey A

Hansen, Jeffrey A is an sole proprietor health care provider with primary practice located at 12187 Deer Flat Rd , Nampa ID 83686-9119. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Hansen, Jeffrey A can be contacted via phone (208) 880-0576.

Contact Information

Primary practice address
12187 Deer Flat Rd Nampa ID 83686-9119
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X M5246 Idaho

Profile Details

NPI number 1932199981
LBN Legal business name Hansen, Jeffrey A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 21st, 2005
Last updated Dec 28th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932199981 NPPES
Idaho Other 000010004475 BLUE SHIELD
Idaho MEDICAID 002364400 BLUE SHIELD
Idaho Other 080036990 BLUE SHIELD
Idaho Other 52464 BLUE SHIELD
Idaho Other 806359900 BLUE SHIELD

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