Provider Demographics
NPI:1023337946
Name:HANSON, HOLLY CHRISTINE (MD)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:CHRISTINE
Last Name:HANSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:HOLLY
Other - Middle Name:CHRISTINE
Other - Last Name:ENGASSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:18315 CASCADE DR.
Mailing Address - Street 2:SUITE 150
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55347
Mailing Address - Country:US
Mailing Address - Phone:952-934-7336
Mailing Address - Fax:952-934-7488
Practice Address - Street 1:18315 CASCADE DR.
Practice Address - Street 2:SUITE 150
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55347
Practice Address - Country:US
Practice Address - Phone:952-934-7336
Practice Address - Fax:952-934-7488
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-18
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN55607207N00000X, 207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology