Provider Demographics
NPI:1083755508
Name:HANSEN, DORRIE ANN (RN)
Entity type:Individual
Prefix:MRS
First Name:DORRIE
Middle Name:ANN
Last Name:HANSEN
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 DOVE ST
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54902-3302
Mailing Address - Country:US
Mailing Address - Phone:715-802-3539
Mailing Address - Fax:
Practice Address - Street 1:2310 N MAIN ST
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54901-1934
Practice Address - Country:US
Practice Address - Phone:920-231-1543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI129164-030163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40003700OtherPRIVATE DUTY RN