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NPI Code Detail

MEDICARE: BROOKE MICHELLE HANSEN NP

MEDICARE: BROOKE MICHELLE HANSEN NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner71011897AIN

General Provider Information

NPI Number : 1164189361
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKE MICHELLE HANSEN NP
Provider Business Mailing Address
First Line : 2980 COUNTRY CLUB CT
Second Line :
City : MARTINSVILLE
State : IN
Zip : 46151-7508
Country : US
Telephone Number : 317-362-5653
Fax Number :
Provider Business Practice Location Address
First Line : 1701 N SENATE BLVD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-1239
Country : US
Telephone Number : 317-963-1300
Fax Number : 317-222-2012
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2021
Last Update Date : 03/02/2026

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Directions to “ BROOKE MICHELLE HANSEN NP” Practice Location

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