Provider Demographics
NPI:1992045082
Name:HANSEN, KERI ANNE (MS, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:KERI
Middle Name:ANNE
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 STATE ST
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:SD
Mailing Address - Zip Code:57014-2300
Mailing Address - Country:US
Mailing Address - Phone:605-359-0605
Mailing Address - Fax:
Practice Address - Street 1:2201 STATE ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:SD
Practice Address - Zip Code:57014-2300
Practice Address - Country:US
Practice Address - Phone:605-359-0605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-26
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13242225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist