| NPI | 1053724856 |
|---|---|
| Former Name | MICHELLE HANSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 7661406-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 7661406-4405) |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2021-08-16 |