Healthcare Provider Details

I. General information

NPI: 1811916406
Provider Name (Legal Business Name): JANET K HANSEN AUDIOLOGIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 11/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 PARK AVE
MINNEAPOLIS MN
55415-1623
US

IV. Provider business mailing address

701 PARK AVE
MINNEAPOLIS MN
55415-1623
US

V. Phone/Fax

Practice location:
  • Phone: 612-873-6173
  • Fax: 612-630-8230
Mailing address:
  • Phone: 612-873-6005
  • Fax: 612-630-8242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number5976
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: