Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | R 156736-4 | MN |
NPI | 1023191343 |
---|---|
Provider Name | Mrs. Jamie Marie Hansberger |
First Address | Sioux Falls, SD 57103-8607 |
Second Address | Sioux Falls, SD 57104-4663 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 28/05/2010 |