Joshua Hansen, PA-C

NPI 1588948087 · on the registry since 2011 · sole proprietor

Practice

Address: 1880 John Adams Pkwy
Idaho Falls, ID 83401
Phone: (208) 524-6633
Organisation at this address: Wallace C Baker
Wallace Bakers Mid-Level Group
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 8

Registry record

Primary taxonomy: 363AM0700X
363AM0700X
Also registered as: 363AS0400X
Licence states on file: ID
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2011-10-18

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho