Individual
JENNIFER HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
560 PIERCE ST, KINGSTON, PA 18704-5716
(570) 283-2161
(570) 714-0670
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS015876
PA
207R00000X
Internal Medicine Physician
OT013450
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
448100
MEDICARE NUMBER
PA
Enumeration date
06/21/2010
Last updated
08/31/2020
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