Individual
CALLIE ELIZABETH HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4855 S MOORLAND RD, NEW BERLIN, WI 53151-7494
(262) 432-7599
(262) 432-7694
Mailing address
9000 W WISCONSIN AVE # MS 958, MILWAUKEE, WI 53226-4874
(262) 432-7599
(262) 432-7694
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
74482-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700140563
—
WI
Enumeration date
06/26/2012
Last updated
03/01/2021
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