Provider Demographics
NPI:1033404496
Name:HANSON, COURTNEY (APNP)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:
Last Name:HANSON
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:MISS
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:REAP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, ACNP-BC, APNP
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-5700
Mailing Address - Fax:414-454-0152
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-5700
Practice Address - Fax:414-454-0152
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI165105163W00000X
WI4561-33363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1033404496Medicaid