Individual
KEVIN MICHAEL HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2851 UNIVERSITY AVE, GREEN BAY, WI 54311-5855
(920) 265-9687
Mailing address
4318 FOREST RIDGE DR, SUAMICO, WI 54313-8557
(920) 265-9687
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
76317-20
WI
Other
Enumeration date
04/28/2020
Last updated
08/06/2024
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