Individual
KRISTINE MARIE HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1501 S MADISON ST, APPLETON, WI 54915-1846
(920) 720-1623
(920) 720-1902
Mailing address
1630 PEACH TREE COURT, KAUKAUNA, WI 54130
(920) 759-9212
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
749033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43834300
—
WI
01
—
P00269265
RR MEDICARE
WI
Enumeration date
11/01/2006
Last updated
11/30/2007
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