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NPI Code Detail

MEDICARE: KATELYN HANSEN

MEDICARE: KATELYN HANSEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant

General Provider Information

NPI Number : 1023721198
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATELYN HANSEN
Provider Business Mailing Address
First Line : 2133 CONCORD DR
Second Line :
City : BILLINGS
State : MT
Zip : 59102-5715
Country : US
Telephone Number : 406-794-4635
Fax Number :
Provider Business Practice Location Address
First Line : 1700 WADSWORTH BLVD
Second Line :
City : LAKEWOOD
State : CO
Zip : 80214-5256
Country : US
Telephone Number : 303-238-1488
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2023
Last Update Date : 01/03/2023

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Directions to “ KATELYN HANSEN ” Practice Location

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