| Doctor Name: | MR. ORRIN BLAKE HANSEN |
| NPI Number: | 1104916543 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | APRN |
| License Number: | 282878-4405 |
| Business Practice Address: | 127 E Main St Suite E Lehi, UT - 840432288 |
| Business Phone Number: | 8017669822 |
| Business Fax Number: | 8017669441 |
| Mailing Address: | 127 E Main St, Suite E LEHI |
| State: | UT |
| Postal Code: | 840432288 |
| Phone Number: | 8017669822 |
| Fax Number: | 8017669441 |
| NPI Enumeration Date: | 10/14/2006 |
| NPI Last Update Date: | 06/24/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 282878-4405 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |