Healthcare Provider Details

I. General information

NPI: 1417968462
Provider Name (Legal Business Name): JILL MARIE HANSEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ZABLOCKI DEPARTMENT OF VETERAN AFFAIRS MEDICAL CTR 5000 WEST NATIONAL AVENUE
MILWAUKEE WI
53295-0001
US

IV. Provider business mailing address

N71W29845 RIDGEVIEW LN
HARTLAND WI
53029-9163
US

V. Phone/Fax

Practice location:
  • Phone: 414-384-2000
  • Fax: 414-389-4276
Mailing address:
  • Phone: 414-745-3172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number13759-40
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: