Individual
JOANNA HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
3707 DOTY RD STE G, WOODSTOCK, IL 60098-7530
(815) 334-5018
(815) 206-2822
Mailing address
3701 DOTY RD, WOODSTOCK, IL 60098-7509
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209020088
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
209020088
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209020088
ADVANCED PRACTICE REGISTERED NURSE
IL
Enumeration date
09/23/2019
Last updated
11/13/2019
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