Provider Demographics
NPI:1215546171
Name:ROBERTS, HANNAH LYNN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:LYNN
Last Name:ROBERTS
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 1:2256 ALICE RD
Mailing Address - Street 2:
Mailing Address - City:COXS MILLS
Mailing Address - State:WV
Mailing Address - Zip Code:26342-8131
Mailing Address - Country:US
Mailing Address - Phone:304-266-4050
Mailing Address - Fax:
Practice Address - Street 1:3400 DUDLEY AVE
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26104-1810
Practice Address - Country:US
Practice Address - Phone:304-428-0946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0012184183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist