Provider Demographics
NPI:1609162882
Name:HANNA, ANNETTE MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:MARIE
Last Name:HANNA
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 1:2005 TOWN CENTER PLZ
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-4957
Mailing Address - Country:US
Mailing Address - Phone:916-384-0978
Mailing Address - Fax:916-372-8887
Practice Address - Street 1:2005 TOWN CENTER PLZ
Practice Address - Street 2:T2268
Practice Address - City:WEST SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95691-4957
Practice Address - Country:US
Practice Address - Phone:916-384-0978
Practice Address - Fax:916-372-8887
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-25
Last Update Date:2011-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH55770183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist