Provider Demographics
NPI:1528235082
Name:BESIADA HANSEN, KAREN (OTR)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BESIADA HANSEN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:BESIADA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:2900 CURRY LN
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-5857
Mailing Address - Country:US
Mailing Address - Phone:920-496-4700
Mailing Address - Fax:
Practice Address - Street 1:835 POTTS AVE
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54304-4535
Practice Address - Country:US
Practice Address - Phone:920-491-9079
Practice Address - Fax:920-491-9082
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI849-0262083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine