Individual
KIERSTAN HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
611 E DOUGLAS RD, SUITE 412, MISHAWAKA, IN 46545-1464
(574) 335-6503
Mailing address
10627 DIEBOLD RD, FORT WAYNE, IN 46845-8606
(260) 240-2745
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
26022910A
IN
1835P1200X
Pharmacotherapy Pharmacist
5302039366
MI
Other
Enumeration date
01/16/2014
Last updated
01/11/2016
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