Individual
JACKIE M HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 N PALM CANYON DR # A1-A4, PALM SPRINGS, CA 92262-1868
(760) 424-5602
Mailing address
2500 N PALM CANYON DR # A1-A4, PALM SPRINGS, CA 92262-1868
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
729032
CA
Other
Enumeration date
02/16/2023
Last updated
02/16/2023
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