MEDICARE: STACI HANS RN

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
1	163WE0003X	Emergency Registered Nurse	28274077A	IN

General Provider Information

NPI Number	:	1235967506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACI HANS RN

Provider Business Mailing Address
First Line	:	3516 E 10TH ST
Second Line	:
City	:	JEFFERSONVILLE
State	:	IN
Zip	:	47130-9315
Country	:	US
Telephone Number	:	812-542-4642
Fax Number	:

Provider Business Practice Location Address
First Line	:	3516 E 10TH ST
Second Line	:
City	:	JEFFERSONVILLE
State	:	IN
Zip	:	47130-9315
Country	:	US
Telephone Number	:	812-542-4640
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2024
Last Update Date	:	12/06/2025

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