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General NPI Number Information
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NPI Number | 1396345179
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Entity Type | Individual
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Provider Name | KATE HANSELMAN PMHNP
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Gender | Female
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Dates
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Enumeration Date | 10/29/2020
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Last Update Date | 08/27/2021
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Provider Practice Location Address
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Address Line | 224 SAINT JOHN ST # 3L
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City | NEW HAVEN
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State | CT
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Zip | 06511-4917
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Country | US
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Telephone | 978-621-2592
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Fax |
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Provider Business Mailing Address
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Address Line | 20 DUGGAN RD
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City | ACTON
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State | MA
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Zip | 01720-2039
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Country | US
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Telephone |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 9302
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License Number State | CT
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