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Individual

PAMELA A HANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1315 MEMORIAL DR, MENDOTA, IL 61342-1447
(815) 539-1422
(815) 539-1436
Mailing address
1315 MEMORIAL DR, MENDOTA, IL 61342-1447
(815) 539-1422
(815) 539-1436

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-000486
IL

Other

Enumeration date
11/24/2006
Last updated
04/13/2009
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