Provider Demographics
NPI:1134795859
Name:HANSON, PATRICIA IPPOLITO (CNM)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:IPPOLITO
Last Name:HANSON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 COLISEUM DR STE 280
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-5974
Mailing Address - Country:US
Mailing Address - Phone:757-827-2455
Mailing Address - Fax:757-452-5773
Practice Address - Street 1:4000 COLISEUM DR STE 280
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-5974
Practice Address - Country:US
Practice Address - Phone:757-827-2455
Practice Address - Fax:757-452-5773
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-02
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC795176B00000X
176B00000X
VA0024192846367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife