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General NPI Number Information
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NPI Number | 1164189361
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Entity Type | Individual
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Provider Name | BROOKE MICHELLE HANSEN NP
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Gender | Female
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Dates
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Enumeration Date | 11/22/2021
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 163 BUTNER DR
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City | HOPE
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State | IN
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Zip | 47246-9447
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Country | US
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Telephone | 812-546-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 1119 LAZIO CT
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City | GREENWOOD
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State | IN
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Zip | 46143-6354
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Country | US
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Telephone | 317-362-5653
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71011897A
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License Number State | IN
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