Provider Demographics
NPI:1619918992
Name:HANSEN, SARAH P (MD)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:P
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1111 DELAFIELD STREET
Mailing Address - Street 2:SUITE 115
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188
Mailing Address - Country:US
Mailing Address - Phone:262-542-2536
Mailing Address - Fax:262-542-2791
Practice Address - Street 1:1111 DELAFIELD STREET
Practice Address - Street 2:SUITE 115
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188
Practice Address - Country:US
Practice Address - Phone:262-542-2536
Practice Address - Fax:262-542-2791
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI47397-0202080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34841400Medicaid
WII60045Medicare UPIN