Healthcare Provider Details

I. General information

NPI: 1427879220
Provider Name (Legal Business Name): NATALIE HANSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2024
Last Update Date: 10/23/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 MAIN ST
PLAIN WI
53577-9668
US

IV. Provider business mailing address

825 MAIN ST
PLAIN WI
53577-9668
US

V. Phone/Fax

Practice location:
  • Phone: 608-546-4211
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number16094-33
License Number StateWI

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: