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Individual

VICKI HANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
206 N ARCADE ST, MAQUOKETA, IA 52060-2022
(563) 652-6711
Mailing address
206 N ARCADE ST, MAQUOKETA, IA 52060-2022
(563) 652-6711

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A108661
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PENDING
MEDICARE
IA
05
PENDING
IA
Enumeration date
11/07/2016
Last updated
03/06/2024
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