Individual
LAURA REBECCA HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
14700 LAC LAVON DR, BURNSVILLE, MN 55306-6398
(952) 432-4471
Mailing address
6493 TANAGER LN, EDEN PRAIRIE, MN 55346-1811
(952) 334-4542
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
120123
MN
Other
Enumeration date
10/21/2011
Last updated
10/21/2011
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