Individual
DR. BROOKE LANE HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
370 E 9TH AVE STE 205, SALT LAKE CITY, UT 84103-3184
(801) 408-6100
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 408-6100
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
8153301-1205
UT
Other
Enumeration date
04/14/2010
Last updated
10/07/2020
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