| Doctor Name: | DR. LARRY LAMONT HANSEN |
| NPI Number: | 1477549624 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 17545 |
| Business Practice Address: | 3016 W Faidley Ave Grand Island, NE - 688034109 |
| Business Phone Number: | 3083818546 |
| Business Fax Number: | 3083818550 |
| Mailing Address: | 3016 W Faidley Ave, GRAND ISLAND |
| State: | NE |
| Postal Code: | 688034109 |
| Phone Number: | 3083818546 |
| Fax Number: | 3083818550 |
| NPI Enumeration Date: | 09/23/2005 |
| NPI Last Update Date: | 12/02/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 17545 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |