Provider Demographics
NPI:1417573890
Name:HANSEN, KRISTEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:
Last Name:HANSEN
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 1:108 NE TOPAZ DR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-7022
Mailing Address - Country:US
Mailing Address - Phone:816-898-4588
Mailing Address - Fax:
Practice Address - Street 1:4545 S NOLAND RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-4887
Practice Address - Country:US
Practice Address - Phone:816-478-1968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016028549183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist