| NPI | 1740701150 |
|---|---|
| Former Name | TESS CARON HANSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 7738) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 7738-33) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 7738) | |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2021-01-19 |