Provider Demographics
NPI:1750844411
Name:HANSEN, ERIN COLLEEN (DOCTOR OF PHARMACY)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:COLLEEN
Last Name:HANSEN
Suffix:
Gender:F
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30523 BUTLER AVE
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613
Mailing Address - Country:US
Mailing Address - Phone:319-266-0741
Mailing Address - Fax:
Practice Address - Street 1:2710 SAINT FRANCIS DR STE 101
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-5633
Practice Address - Country:US
Practice Address - Phone:319-272-5570
Practice Address - Fax:319-272-0188
Is Sole Proprietor?:No
Enumeration Date:2019-04-10
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19494183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist