Provider Demographics
NPI:1649770967
Name:HANSON, SADIE MICHELL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SADIE
Middle Name:MICHELL
Last Name:HANSON
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 1:1401 S DEWEY ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-7622
Mailing Address - Country:US
Mailing Address - Phone:308-532-5830
Mailing Address - Fax:308-532-6069
Practice Address - Street 1:1401 S DEWEY ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-7622
Practice Address - Country:US
Practice Address - Phone:308-532-5830
Practice Address - Fax:308-532-6069
Is Sole Proprietor?:No
Enumeration Date:2018-02-13
Last Update Date:2018-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE15382183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist