MEDICARE: MRS. WENDY M HANSEN-PENMAN D.O.

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	207Q00000X	Family Medicine Physician	3733	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801998372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. WENDY M HANSEN-PENMAN D.O.

Provider Business Mailing Address
First Line	:	1801 HICKMAN ROAD
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50314-1597
Country	:	US
Telephone Number	:	515-282-2200
Fax Number	:	515-282-7823

Provider Business Practice Location Address
First Line	:	1801 HICKMAN ROAD
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50314-1597
Country	:	US
Telephone Number	:	515-282-2200
Fax Number	:	515-282-7823

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

Provider Enumeration Date	:	09/03/2006
Last Update Date	:	12/11/2013

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Directions to “ MRS. WENDY M HANSEN-PENMAN D.O.” Practice Location

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