Individual
RITA MARIE HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13950 W CAPITOL DR, BROOKFIELD, WI 53005-2441
(414) 302-5404
Mailing address
13950 W CAPITOL DR, BROOKFIELD, WI 53005-2441
(414) 302-5404
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20894
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30266500
—
WI
01
—
3908168571A4
BLUE CROSS BLUE SHIELD
—
Enumeration date
01/02/2007
Last updated
08/30/2010
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