Provider Demographics
NPI:1306835376
Name:HANSEN, DEBRA J (PHARMD, RP)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:J
Last Name:HANSEN
Suffix:
Gender:F
Credentials:PHARMD, RP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3215 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-3329
Mailing Address - Country:US
Mailing Address - Phone:308-236-7892
Mailing Address - Fax:
Practice Address - Street 1:10 E 31ST ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-2926
Practice Address - Country:US
Practice Address - Phone:308-854-7022
Practice Address - Fax:308-865-2946
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9354183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist