Provider Demographics
NPI:1144588088
Name:HANNEMANN, LAUREN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:HANNEMANN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 WATERFRONT PLZ
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:VT
Mailing Address - Zip Code:05855-4877
Mailing Address - Country:US
Mailing Address - Phone:802-334-6785
Mailing Address - Fax:802-334-2298
Practice Address - Street 1:59 WATERFRONT PLZ
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:VT
Practice Address - Zip Code:05855-4877
Practice Address - Country:US
Practice Address - Phone:802-334-6785
Practice Address - Fax:802-334-2298
Is Sole Proprietor?:No
Enumeration Date:2012-04-29
Last Update Date:2012-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033.0076583183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist