Provider Demographics
NPI:1861617375
Name:HANSEN, SHARON SMITH (RN, CDE)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:SMITH
Last Name:HANSEN
Suffix:
Gender:F
Credentials:RN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HOPPIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4132
Mailing Address - Country:US
Mailing Address - Phone:401-444-8222
Mailing Address - Fax:401-444-7870
Practice Address - Street 1:1 HOPPIN ST STE 200
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4132
Practice Address - Country:US
Practice Address - Phone:401-444-8222
Practice Address - Fax:401-444-7870
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN16109163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator