Individual
MELISSA HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.P.N.P.
Contact information
Practice address
14135 CEDAR AVE, SUITE 100, APPLE VALLEY, MN 55124-4522
(952) 432-4373
(952) 997-5679
Mailing address
14135 CEDAR AVE, SUITE 100, APPLE VALLEY, MN 55124-4522
(952) 432-4373
(952) 997-5679
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R115625-4
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
605323800
—
MN
Enumeration date
08/19/2005
Last updated
10/25/2012
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