Individual
BONNIE SUE HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2916 PEAVEY ST, PORT HURON, MI 48060-6987
(810) 990-5304
Mailing address
2916 PEAVEY ST, PORT HURON, MI 48060-6987
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704226709
MI
Other
Enumeration date
12/20/2018
Last updated
12/20/2018
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