Provider Demographics
NPI:1710542089
Name:FLACH, HANNAH KIRSTEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:KIRSTEN
Last Name:FLACH
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 1:2766 41ST ST S APT 404
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-9096
Mailing Address - Country:US
Mailing Address - Phone:701-541-2412
Mailing Address - Fax:
Practice Address - Street 1:3301 HIGHWAY 10 E
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-2516
Practice Address - Country:US
Practice Address - Phone:218-233-2953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-02
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN123909183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist