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Individual

SUSAN M TESCHAN-HANSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1310 BROADWAY, WISCONSIN DELLS, WI 53965-1358
(608) 253-1171
(608) 253-8012
Mailing address
1310 BROADWAY, WISCONSIN DELLS, WI 53965-1358
(608) 253-1171
(608) 253-8012

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
392-23
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1669606653
WI
Enumeration date
05/06/2009
Last updated
04/26/2016
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