Individual
JENNIFER HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
27351 DEQUINDRE RD, MADISON HEIGHTS, MI 48071-3487
(248) 967-7795
(248) 967-7794
Mailing address
27351 DEQUINDRE RD, MADISON HEIGHTS, MI 48071-3487
(248) 967-7795
(248) 967-7794
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
5101017511
MI
207P00000X
Emergency Medicine Physician
Primary
N8516
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280850301
—
TX
05
—
280850302
—
TX
01
—
P00944848
MEDICARE RAILROAD
TX
Enumeration date
08/22/2007
Last updated
10/24/2011
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