Individual
STACY JO HANSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
800 E 28TH ST, MINNEAPOLIS, MN 55407-3723
(612) 871-7639
(612) 872-0302
Mailing address
2545 CHICAGO AVE, MINNEAPOLIS, MN 55404-4522
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R 130618-5
MN
Other
Enumeration date
03/23/2006
Last updated
07/08/2007
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