Most Relevant Information
Provider Data
| NPI Number: | 1003530429 |
| Provider Name: | LISA MARIE HANSON NP |
| Entity Type: | Individual |
| Taxonomy Code: | 207QA0505X |
| Specialty: | Family Medicine |
| License Number: | 5984518-4405 |
Most Important Dates
| Enumeration Date: | 09/29/2022 |
| Last Updated: | 09/29/2022 |
Provider Practice Location
4538 W SOUTH JORDAN PKWY UNIT 110
SOUTH JORDAN
UT
840095852
Practice Location Phone/Fax
| Phone: | 8016616052 |
| Fax: |
Provider Mailing Location
4538 W SOUTH JORDAN PKWY UNIT 110
SOUTH JORDAN
UT
840095852
Provider Mailing Phone/Fax
| Phone: | 8016616052 |
| Fax: |