Individual
DR. SUSAN N HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD/LN,PHD
Contact information
Practice address
113 COMANCHE RD, FORT MEADE, SD 57741-1002
(605) 720-7090
(605) 720-7012
Mailing address
113 COMANCHE RD, FORT MEADE, SD 57741-1002
(605) 469-1170
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
0514
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5540030
—
SD
Enumeration date
06/22/2009
Last updated
06/10/2015
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