1922236223 NPI number — MRS. JENNIFER M HANSON RN, NP

Table of content: MRS. JENNIFER M HANSON RN, NP (NPI 1922236223)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922236223 NPI number — MRS. JENNIFER M HANSON RN, NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HANSON
Provider First Name:
JENNIFER
Provider Middle Name:
M
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN, NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922236223
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/07/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8674
Provider Second Line Business Mailing Address:
1230 E. MAIN STREET MANKATO CLINIC, LTD
Provider Business Mailing Address City Name:
MANKATO
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
56002-8674
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
507-625-1811
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
205 ORCHARD DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SISSETON
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57262-2312
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-698-4665
Provider Business Practice Location Address Fax Number:
605-698-6401
Provider Enumeration Date:
06/24/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  R189007-3 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2200X , with the licence number: R189007-3 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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