Individual
ELIZABETH M CHU HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
830 OAK STREET, SUITE 123E, BROCKTON, MA 02301
(617) 526-5359
(617) 562-5415
Mailing address
77 WARREN STREET, 3RD FL, PROVIDER ENROLLMENT DEPT, BRIGHTON, MA 02135
(617) 562-5359
(617) 562-5415
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
133138
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0366650
—
MA
Enumeration date
11/07/2005
Last updated
07/08/2007
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