Individual
MRS. NICOLE M HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1118 N MAIN ST, BREWER, ME 04412-1238
(207) 989-9827
Mailing address
1118 N MAIN ST, BREWER, ME 04412-1238
(207) 989-9827
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
198990000
PROVIDER NUMBER FOR MECMS
ME
Enumeration date
01/25/2007
Last updated
07/08/2007
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