Individual
SUZANNE HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8040 CLEARVISTA PKWY, SUITE 520, INDIANAPOLIS, IN 46256-5630
(317) 621-2400
Mailing address
8040 CLEARVISTA PKWY, SUITE 520, INDIANAPOLIS, IN 46256-5630
(317) 621-2400
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01059112A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000329517
ANTHEM
IN
01
—
P00241909
RR MEDICARE
IN
Enumeration date
07/25/2006
Last updated
11/05/2007
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