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Individual
AMY JO HANNEMAN
Active
Individual
AMY JO HANNEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN MSN AGNP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
113915-30
WI
363LG0600X
Gerontology Nurse Practitioner
113915-30
WI
Other
Enumeration date
01/14/2015
Last updated
01/14/2015
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