Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mac Jacob Hansen

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1114640554

Mac Jacob Hansen is a Student in an Organized Health Care Education/Training Program in Burnsville, Minnesota. Registered with an NPI since 2022.

In the registry since
2022

Practice location Address checks out

1705 Southcross Dr W Ste 101
Burnsville, MN 55306-7012
Phone: (952) 225-1575
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1114640554
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 21, 2022
Last updated in NPPESSeptember 21, 2022
Certification dateSeptember 21, 2022
Mailing addressPo Box 363, Farmington, MN 55024-0363

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