Provider Demographics
NPI:1144478637
Name:HANSEN, ANNE VENABLE EDMUNDS (MD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:VENABLE EDMUNDS
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 BOWYER LANE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450
Mailing Address - Country:US
Mailing Address - Phone:540-460-8044
Mailing Address - Fax:
Practice Address - Street 1:515 8TH ST. SW
Practice Address - Street 2:ROANOKE/ALLEGHENY HEALTH DEPARTMENT
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016
Practice Address - Country:US
Practice Address - Phone:540-857-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012388382083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine