Provider Demographics
NPI:1194008672
Name:MUNIZ-HANSEN, REBECCA L (RPH)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
Last Name:MUNIZ-HANSEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 IRVING ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-5045
Mailing Address - Country:US
Mailing Address - Phone:303-679-1427
Mailing Address - Fax:
Practice Address - Street 1:650 S CHERRY ST
Practice Address - Street 2:#300
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-1801
Practice Address - Country:US
Practice Address - Phone:303-794-3220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17474183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist