Individual
LAUREN HAZEL HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2863 HIGHWAY 45 BYP, JACKSON, TN 38305-3618
(731) 422-0213
Mailing address
PO BOX 400, JACKSON, TN 38302-0400
(731) 425-5752
(731) 422-5743
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
05045
KY
207Q00000X
Family Medicine Physician
Primary
4414
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100649700
—
KY
01
—
K332600
MEDICARE
KY
Enumeration date
04/10/2018
Last updated
03/02/2023
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