Individual
DIANNE M HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN,C AHN-BC, LMT
Contact information
Practice address
732 LARPENTEUR AVE W, SAINT PAUL, MN 55113-6558
(651) 785-8279
Mailing address
1769 LEXINGTON AVE N, N #236, SAINT PAUL, MN 55113-6522
(651) 785-8279
Taxonomy
Speciality
Code
Description
License number
State
163WM1400X
Nurse Massage Therapist (NMT)
Primary
20040004594
MN
163WN1003X
Nutrition Support Registered Nurse
R110668-6
MN
163WR0400X
Rehabilitation Registered Nurse
R110668-6
MN
Other
Enumeration date
07/14/2010
Last updated
07/14/2010
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