Provider Demographics
NPI:1629687561
Name:HANSEN, BRIANNA CHRISTINE
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:CHRISTINE
Last Name:HANSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:CHRISTINE
Other - Last Name:WEGNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 242
Mailing Address - Street 2:
Mailing Address - City:BANCROFT
Mailing Address - State:NE
Mailing Address - Zip Code:68004-0242
Mailing Address - Country:US
Mailing Address - Phone:402-380-5959
Mailing Address - Fax:
Practice Address - Street 1:408 PARK ST
Practice Address - Street 2:
Practice Address - City:BANCROFT
Practice Address - State:NE
Practice Address - Zip Code:68004-4097
Practice Address - Country:US
Practice Address - Phone:402-380-5959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist