Provider Demographics
NPI:1639117500
Name:HANSEN, KAREN NINA (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:NINA
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2043 HUNTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GAMBRILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21054-2034
Mailing Address - Country:US
Mailing Address - Phone:410-721-8699
Mailing Address - Fax:410-451-6687
Practice Address - Street 1:110 S PACA ST
Practice Address - Street 2:SIXTH FLOOR, SUITE 200
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1609
Practice Address - Country:US
Practice Address - Phone:410-328-8025
Practice Address - Fax:410-328-8028
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD35449207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDF01419Medicare UPIN