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NPI Code Detail

MEDICARE: MADISON HANSEN RN

MEDICARE: MADISON HANSEN 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
1163WS0200XSchool Registered Nurse79938NE

General Provider Information

NPI Number : 1902387954
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADISON HANSEN RN
Provider Business Mailing Address
First Line : 1305 HOWARD AVE
Second Line :
City : SAINT PAUL
State : NE
Zip : 68873-1402
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1305 HOWARD AVE
Second Line :
City : SAINT PAUL
State : NE
Zip : 68873-1402
Country : US
Telephone Number : 308-754-4433
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2018
Last Update Date : 08/28/2018

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