=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972409860
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MRS. DEBRA JEAN HANZEL
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/16/2026
-----------------------------------------------------
Last Update Date | 10/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14803 JEWEL RD
-----------------------------------------------------
City | VIOLA
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54664-8716
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-604-9840
-----------------------------------------------------
Fax | 608-627-1193
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14803 JEWEL RD
-----------------------------------------------------
City | VIOLA
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 54664-8716
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-604-9840
-----------------------------------------------------
Fax | 608-627-1193
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 311ZA0620X
-----------------------------------------------------
Taxonomy Name | Adult Care Home Facility
-----------------------------------------------------
License Number | 190080
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------