Individual
DR. KELLY LYNNE HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
8605 EASTHAVEN CT, SUITE 101, TRINITY, FL 34655-5216
(727) 372-1130
(727) 373-1132
Mailing address
70 DEERPATH CT, OLDSMAR, FL 34677-2054
(727) 786-4010
(727) 934-1773
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AY296
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51460
BCBS- UAW
—
Enumeration date
10/28/2005
Last updated
02/05/2009
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