Individual
CAROL ELIZABETH HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNC FNP
Contact information
Practice address
80 CONGRESS ST, SPRINGFIELD, MA 01104-3564
(413) 732-0040
(413) 732-7007
Mailing address
12 WAGON DR, WILBRAHAM, MA 01095-1678
(413) 599-1356
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
126357
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110089946A
—
MA
Enumeration date
05/29/2007
Last updated
01/27/2013
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