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General NPI Number Information
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NPI Number | 1215272760
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Entity Type | Individual
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Provider Name | JENNIFER A HANSON R.D., L.D.,
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Gender | Female
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Dates
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Enumeration Date | 12/10/2012
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Last Update Date | 12/10/2012
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Provider Practice Location Address
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Address Line | 600 CAISSON HILL RD NUTRITION CARE
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City | FORT RILEY
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State | KS
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Zip | 66442-7037
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Country | US
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Telephone | 785-239-7644
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Fax |
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Provider Business Mailing Address
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Address Line | SCHOOL OF HUMAN ECOLOGY P.O. BOX 3167
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City | RUSTON
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State | LA
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Zip | 71272-0001
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Country | US
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Telephone | 318-257-2370
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Fax | 318-257-4014
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 1271
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License Number State | KS
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