Provider Demographics
NPI:1598014391
Name:HANSON, SHARON H (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:H
Last Name:HANSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:SHARON
Other - Middle Name:K
Other - Last Name:HAMMERICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:PO BOX 7
Mailing Address - Street 2:712 TILLOTSON ST.
Mailing Address - City:TRINIDAD
Mailing Address - State:CO
Mailing Address - Zip Code:81082-0007
Mailing Address - Country:US
Mailing Address - Phone:719-859-2225
Mailing Address - Fax:
Practice Address - Street 1:712 TILLOTSON ST
Practice Address - Street 2:
Practice Address - City:TRINIDAD
Practice Address - State:CO
Practice Address - Zip Code:81082-2325
Practice Address - Country:US
Practice Address - Phone:719-859-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO11179183500000X
CA33141183500000X
IN26017521A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist