Provider Demographics
NPI:1356821490
Name:HANSON, JENNIFER CHRISTINE (DNP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:CHRISTINE
Last Name:HANSON
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N8739 COUNTY ROAD VV
Mailing Address - Street 2:
Mailing Address - City:MINDORO
Mailing Address - State:WI
Mailing Address - Zip Code:54644-8701
Mailing Address - Country:US
Mailing Address - Phone:608-792-7748
Mailing Address - Fax:
Practice Address - Street 1:711 W ADAMS ST
Practice Address - Street 2:
Practice Address - City:BLACK RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54615-9108
Practice Address - Country:US
Practice Address - Phone:715-284-5361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8579-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily