Provider Demographics
NPI:1003356346
Name:HANSEN, COLEEN (RN)
Entity Type:Individual
Prefix:
First Name:COLEEN
Middle Name:
Last Name:HANSEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S 74TH PLZ
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-4675
Mailing Address - Country:US
Mailing Address - Phone:402-444-6500
Mailing Address - Fax:402-444-6504
Practice Address - Street 1:900 S 74TH PLZ
Practice Address - Street 2:SUITE 200
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4675
Practice Address - Country:US
Practice Address - Phone:402-444-6500
Practice Address - Fax:402-444-6504
Is Sole Proprietor?:No
Enumeration Date:2017-03-06
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE40101163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse