Provider Demographics
NPI:1053417857
Name:HANSFORD-ORSBURN, SUSAN R (FNP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:R
Last Name:HANSFORD-ORSBURN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:R
Other - Last Name:HANSFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:115 E BYPASS 287
Mailing Address - Street 2:
Mailing Address - City:ALVORD
Mailing Address - State:TX
Mailing Address - Zip Code:76225-7778
Mailing Address - Country:US
Mailing Address - Phone:940-427-2858
Mailing Address - Fax:940-627-7464
Practice Address - Street 1:115 E BYPASS 287
Practice Address - Street 2:
Practice Address - City:ALVORD
Practice Address - State:TX
Practice Address - Zip Code:76225-7778
Practice Address - Country:US
Practice Address - Phone:940-428-2858
Practice Address - Fax:866-241-2533
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP106807363L00000X, 363LF0000X
TX254192207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX254192OtherLICENSE
TX254192OtherLICENSE