Individual
BROOKE HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
3944 S 400 E, SALT LAKE CITY, UT 84107-1600
(801) 743-1715
Mailing address
3944 S 400 E, SALT LAKE CITY, UT 84107-1600
(801) 743-1715
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
52709633102
UT
Other
Enumeration date
07/11/2012
Last updated
07/11/2012
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