Provider Demographics
NPI:1679656078
Name:HAHN, ALISHA M (RPH)
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:M
Last Name:HAHN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:208 E. JEFFERSON STREET
Mailing Address - City:SPRING GREEN
Mailing Address - State:WI
Mailing Address - Zip Code:53588-0069
Mailing Address - Country:US
Mailing Address - Phone:608-588-2541
Mailing Address - Fax:608-588-2884
Practice Address - Street 1:208 E. JEFFERSON STREET
Practice Address - Street 2:
Practice Address - City:SPRING GREEN
Practice Address - State:WI
Practice Address - Zip Code:53588-0069
Practice Address - Country:US
Practice Address - Phone:608-588-2541
Practice Address - Fax:608-588-2884
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12489-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist