MRS. JENNA MAE HANSON (NPI# 1003476276) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003476276 |
| Entity Type | Individual |
| Full Name | MRS. JENNA MAE HANSON |
| Credential | PA-C |
| Practice Address |
1715 Dousman St Green Bay WI 54303-3211 |
| Mailing Address |
2749 Moose Creek Trl Suamico WI 54313-3259 |
| Practice Telephone | 9204964770 |
| Mailing Telephone | 7156130986 |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2019-06-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
4705-23 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952731697 | Jenna Hanson | Student in an Organized Health Care Education/Training Program | 2728 Durant Ave, Berkeley, CA 94704-1725 | 2013-11-15 |
| Street Address |
1715 DOUSMAN ST |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54303-3211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629071485 | Gayle M Kasdorf | Internal Medicine | 1715 Dousman St, Green Bay, WI 54303-3211 | 2005-05-24 |
| 1508476771 | Alea Meyer | Audiologist | 1715 Dousman St, Green Bay, WI 54303-3211 | 2020-08-03 |
| 1932672409 | Kaylee Elizabeth Hoppe | Physician Assistant | 1715 Dousman St, Green Bay, WI 54303-3211 | 2019-01-08 |
| 1205307170 | Marjorie Hatszegi | Nurse Practitioner | 1715 Dousman St, Green Bay, WI 54303-3211 | 2018-12-17 |
| 1700362860 | Cassandra Jean Bedore | Audiologist | 1715 Dousman St, Green Bay, WI 54303-3211 | 2018-07-12 |
| 1033632336 | Shilpa Mohan Ullikashi | Pediatrics | 1715 Dousman St, Green Bay, WI 54303-3211 | 2017-07-19 |
| 1811431372 | Lauryn Carlson | Registered Nurse | 1715 Dousman St, Green Bay, WI 54303-3211 | 2016-12-16 |
| 1831543529 | Rachael John | Occupational Therapist | 1715 Dousman St, Green Bay, WI 54303-3211 | 2016-04-19 |
| 1780099911 | Anusha Surender | Internal Medicine | 1715 Dousman St, Green Bay, WI 54303-3211 | 2014-06-26 |
| 1174934806 | Humera Fatima Ahmad | Surgery | 1715 Dousman St, Green Bay, WI 54303-3211 | 2014-05-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952921033 | Ashley Marie Vandermoss | Social Worker | 1601 W Mason Street, Green Bay, WI 54303 | 2020-04-20 |
| 1598307423 | Jean Marie Castaneda | Case Manager/Care Coordinator | 2517 N. Court, Green Bay, WI 54303 | 2019-10-11 |
| 1215579552 | Integrated Treatment Centers, LLC | Clinic/Center | 2311 W Mason Street, Green Bay, WI 54303 | 2019-10-08 |
| 1003460551 | Affordable Dentures & Implants - Green Bay, S.c. | Dentist | 1800-c W. Mason Street, Green Bay, WI 54303 | 2019-08-01 |
| 1164940375 | Kaeley Rae Blaney | Student in an Organized Health Care Education/Training Program | 2088 Memorial Drive #208, Green Bay, WI 54303 | 2017-09-07 |
| 1518498047 | Treatment Providers LLC | Clinic/Center | 2731 N Packerland Dr Ste A, Green Bay, WI 54303 | 2017-03-26 |
| 1851840565 | Back To Balance Chiropractic, LLC | Chiropractor | 110 Packerland Drive, Suite B, Green Bay, WI 54303 | 2016-09-23 |
| 1710361001 | Matthew Lemay | Acupuncturist | 727 E Walnut, Suite B2, Green Bay, WI 54303 | 2015-07-16 |
| 1144600149 | Carrie Jean Banaszak | Counselor | 1039 Mason Street, Green Bay, WI 54303 | 2015-06-04 |
| 1174921993 | Kensey Meyer | Occupational Therapy Assistant | 1555 Dousman Road, Seymour, WI 54303 | 2014-12-10 |
| Find all providers in zip 54303 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275049140 | Miranda Mary Cseter | Physician Assistant | 2793 Lineville Rd, Green Bay, WI 54313-7152 | 2017-12-14 |
| 1437506110 | Jessica Zarzecki | Physician Assistant | 1821 S Webster Ave, Green Bay, WI 54301-2253 | 2016-05-23 |
| 1205219680 | Mitchell J Lind | Physician Assistant | 1630 Commanche Ave, Green Bay, WI 54313-5753 | 2015-07-03 |
| 1164614327 | Kristin M Mccabe | Physician Assistant | 744 S Webster Ave, 2nd Floor, Green Bay, WI 54301-3505 | 2007-08-13 |
| 1538205380 | Gail P Bosco | Physician Assistant | 2430 E Mason St, Green Bay, WI 54302-3759 | 2007-01-29 |
| 1609826171 | Jacquelyn Renee Phillips | Physician Assistant | 744 S Webster Ave, 2nd Floor, Green Bay, WI 54301-3505 | 2006-05-12 |
| 1801898564 | William Robert Conrad | Physician Assistant | 720 S Van Buren St, Suite 301, Green Bay, WI 54301-3538 | 2005-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093348542 | Christopher Sean Lanctin | Physician Assistant | 557 N 17th St Apt 310, Milwaukee, WI 53233-2128 | 2020-02-12 |
| 1750936068 | Javier Eugenio Font | Physician Assistant | 813 N Clover Ln, Cottage Grove, WI 53527-9433 | 2019-08-04 |
| 1962056432 | Lyndsey Marie Bratberg | Physician Assistant | F&mcw Clinical Cancer Center 9200 W. Wisconsin Ave., Milwaukee, WI 53226 | 2019-08-01 |
| 1588225544 | Hannah Elizabeth Krum | Physician Assistant | S80w17784 Brennan Dr, Muskego, WI 53150-8828 | 2019-06-21 |
| 1255825162 | Katelyn Marie Frankwick | Physician Assistant | 1011 E Spruce St # 6, Abbotsford, WI 54405-9647 | 2018-06-15 |
| 1831644228 | Megan E Nelson | Physician Assistant | 221 E Mills Dr, Lake Mills, WI 53551-1910 | 2016-08-16 |
| 1356717904 | Amy Hermus | Physician Assistant | 451 Butternut Dr, Oregon, WI 53575-1349 | 2015-08-18 |
| 1497168066 | Alexander J Hill | Physician Assistant | 1111 North Road, Mauston, WI 53948-0700 | 2014-06-11 |
| 1487083242 | Andrew John Miller | Physician Assistant | 1521 Lakeview Ave, Wausau, WI 54401-6168 | 2013-11-02 |
| 1386944502 | Bethany Rose Yard | Physician Assistant | 18601 Lincoln Street, Whitehall, WI 54773 | 2010-10-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.