Provider Demographics
NPI:1629665427
Name:HANSON, DEEANNA (PHARMD)
Entity Type:Individual
Prefix:
First Name:DEEANNA
Middle Name:
Last Name:HANSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:DEEANNA
Other - Middle Name:
Other - Last Name:ZIEGLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:712 S CASCADE ST
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-2913
Mailing Address - Country:US
Mailing Address - Phone:218-736-8155
Mailing Address - Fax:218-736-8787
Practice Address - Street 1:712 S CASCADE ST
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-2913
Practice Address - Country:US
Practice Address - Phone:218-736-8155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDRPH6124183500000X
MN124278183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist