Individual
KIMBERLY DAWN HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1884 RANDOLPH AVE, SAINT PAUL, MN 55105-1747
(651) 287-7777
Mailing address
1246 NURSERY HILL LN, SAINT PAUL, MN 55112-5712
(651) 210-4004
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
6479
MN
Other
Enumeration date
06/17/2019
Last updated
06/17/2019
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