Most Relevant Information
Provider Data
| NPI Number: | 1003476276 |
| Provider Name: | JENNA MAE HANSON PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363AM0700X |
| Specialty: | Physician Assistant |
| License Number: | 4705-23 |
Most Important Dates
| Enumeration Date: | 06/19/2019 |
| Last Updated: | 06/19/2019 |
Provider Practice Location
1715 DOUSMAN ST
GREEN BAY
WI
543033211
Practice Location Phone/Fax
| Phone: | 9204964770 |
| Fax: |
Provider Mailing Location
2749 MOOSE CREEK TRL
SUAMICO
WI
543133259
Provider Mailing Phone/Fax
| Phone: | 7156130986 |
| Fax: |