Individual
KATLYN SUE HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1550 MIDWAY PL, MENASHA, WI 54952-1165
(920) 727-8000
Mailing address
1550 MIDWAY PL, MENASHA, WI 54952-1165
(920) 727-8000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5658 - 33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100036689
—
WI
Enumeration date
01/30/2014
Last updated
12/19/2023
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