| NPI | 1417398777 |
|---|---|
| Former Name | ELLEN A. HANSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209022372) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.022372) |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2025-01-14 |