Healthcare Provider Details

I. General information

NPI: 1245149772
Provider Name (Legal Business Name): VICTORIA M HANSEN BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MAGGIE HANSEN

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 W NATIONAL AVE
MILWAUKEE WI
53295-0001
US

IV. Provider business mailing address

521 KAREN LN
GREEN BAY WI
54301-2827
US

V. Phone/Fax

Practice location:
  • Phone: 920-431-2457
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number172684-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: