Provider Demographics
NPI:1326894403
Name:HANSE, NICOLE (NTP, INHC, BS-HWM)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:HANSE
Suffix:
Gender:F
Credentials:NTP, INHC, BS-HWM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 N 4TH ST STE 113
Mailing Address - Street 2:
Mailing Address - City:TOMAHAWK
Mailing Address - State:WI
Mailing Address - Zip Code:54487-2153
Mailing Address - Country:US
Mailing Address - Phone:715-966-0555
Mailing Address - Fax:
Practice Address - Street 1:1411 N 4TH ST STE 113
Practice Address - Street 2:
Practice Address - City:TOMAHAWK
Practice Address - State:WI
Practice Address - Zip Code:54487-2153
Practice Address - Country:US
Practice Address - Phone:715-966-0555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach