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Individual

KAITLYN HANSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
3639 OLD STAGE RD, BROOKLYN, WI 53521-9410
(608) 469-0763
Mailing address
3639 OLD STAGE RD, BROOKLYN, WI 53521-9410
(608) 469-0763

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
170025
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8447607984
WI
Enumeration date
07/01/2015
Last updated
07/01/2015
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