Healthcare Provider Details

I. General information

NPI: 1356610349
Provider Name (Legal Business Name): KAREN LILLIAN HANSEN R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2011
Last Update Date: 12/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 UNION ST
POUGHKEEPSIE NY
12601-3014
US

IV. Provider business mailing address

319 MOUNTAIN RD
ROSENDALE NY
12472-9654
US

V. Phone/Fax

Practice location:
  • Phone: 845-451-4882
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number476839
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: