Most Relevant Information
Provider Data
| NPI Number: | 1003685777 |
| Provider Name: | CHARLES I HANSEN |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 140125 |
Most Important Dates
| Enumeration Date: | 12/22/2023 |
| Last Updated: | 12/22/2023 |
Provider Practice Location
444 CENTER ST
MANCHESTER
CT
060403926
Practice Location Phone/Fax
| Phone: | 8607315222 |
| Fax: | 8607315536 |
Provider Mailing Location
2 WATERSIDE XING STE 401
WINDSOR
CT
060951588
Provider Mailing Phone/Fax
| Phone: | 8606973351 |
| Fax: | 8607315536 |