Provider Demographics
NPI:1689945594
Name:HANSELL, SUSAN (RN, BSN, MBA)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:HANSELL
Suffix:
Gender:F
Credentials:RN, BSN, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18321 CLAIRMONT CIR W
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168-8547
Mailing Address - Country:US
Mailing Address - Phone:734-769-7100
Mailing Address - Fax:
Practice Address - Street 1:2215 FULLER ROAD
Practice Address - Street 2:VA ANN ARBOR HEALTHCARE SYSTEM MAIL CODE 111E
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105
Practice Address - Country:US
Practice Address - Phone:734-769-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704275819163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse