Provider Demographics
NPI:1982142154
Name:HANSMAN, SARA (CPM, LM)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:HANSMAN
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 W COLLEGE AVE STE C
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54914-5287
Mailing Address - Country:US
Mailing Address - Phone:920-574-3074
Mailing Address - Fax:920-574-9502
Practice Address - Street 1:1230 W COLLEGE AVE STE C
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914-5287
Practice Address - Country:US
Practice Address - Phone:920-574-3074
Practice Address - Fax:920-574-9502
Is Sole Proprietor?:No
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI49-175176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife