Provider Demographics
NPI:1639589922
Name:ANDERSON, HANNAH (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 N BEAR LAKE RD
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49445-2308
Mailing Address - Country:US
Mailing Address - Phone:231-719-0729
Mailing Address - Fax:
Practice Address - Street 1:700 W NORTON AVE
Practice Address - Street 2:
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49441-4751
Practice Address - Country:US
Practice Address - Phone:231-733-5733
Practice Address - Fax:231-733-5765
Is Sole Proprietor?:No
Enumeration Date:2014-05-07
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020387081835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy