BEVERLY HANSON PA
NPI 1003874389
Physician Assistant - Surgical in Blackfoot, ID

Q: What is the provider's specialty?

The provider's specialty is Physician Assistant with taxonomy code 363AS0400X and a focus in Surgical.

Active since May 03, 2006

98 POPLAR ST, BLACKFOOT, ID 83221(208) 782-3993(208) 782-3994 Get Directions Write a Review

NPPES record last updated: September 9, 2008. Verified against the NPPES registry weekly; last sync: July 19, 2026.

On this page

About Beverly Hanson Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BEVERLY HANSON PA (NPI 1003874389) is an individual surgical provider in Blackfoot, Idaho, licensed in Idaho (PAG-012) and active in the NPI registry since May 2006.

NPPES Registry Identity

NPI1003874389

Entity TypeIndividualFemale

Primary Taxonomy363AS0400X

Provider Legal NameBEVERLY HANSONCredential: PA

Location Address98 POPLAR STBlackfoot, ID 83221-1758

Mailing Address98 Poplar StBlackfoot, ID 83221-1758 · (208) 782-3993 · Fax (208) 782-3994

Phone(208) 782-3993

Fax(208) 782-3994

Sole ProprietorNo

Enumeration DateMay 3, 2006

Last NPPES UpdateSeptember 9, 2008

✔ NPI 1003874389 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

License✔ Licensed in ID · PAG-012

98 POPLAR ST, Blackfoot, ID 83221

Open in Google Maps ↗

Other Identifiers 10

Medicare PIN1667444ID

Medicare PIN16674441ID

Medicaid807338600ID

Medicare UPINP55805ID

Other000010154328ID · Regence Blue Shield

Other000010167603ID · Rbs Lamere

OtherHB405ID · Blue Cross

OtherHPAC6ID · Blue Cross Old

Medicare PINP00456536ID

OtherPAJ80ID · Bcs Lamere

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. WADE H FLOWERS JR. PHARM.D., BCPS, CGP

Pharmacist (Pharmacotherapy)