MEDICARE: CHRISTIAN 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
1	246ZE0600X	Electroneurodiagnostic Specialist/Technologist

General Provider Information

NPI Number	:	1063305498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIAN HANSEN

Provider Business Mailing Address
First Line	:	2622 E 21ST ST STE 2
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74114-1738
Country	:	US
Telephone Number	:	918-895-7680
Fax Number	:

Provider Business Practice Location Address
First Line	:	2622 E 21ST ST STE 2
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74114-1738
Country	:	US
Telephone Number	:	918-895-7680
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2025
Last Update Date	:	06/03/2025

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Directions to “ CHRISTIAN HANSEN ” Practice Location

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