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Individual

WANDA ANDERSON HANNA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.PH.

Contact information

Practice address
1117 POLK ST, MANSFIELD, LA 71052-2524
(318) 871-2976
(866) 575-1502
Mailing address
1117 POLK ST, MANSFIELD, LA 71052-2524
(318) 871-2976
(866) 575-1502

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13327
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13327
LOUISIANA BOARD OF PHARMACY
LA
Enumeration date
02/22/2012
Last updated
02/22/2012
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