Provider Demographics
NPI:1922654508
Name:CHRISTOPHER, HANNA
Entity Type:Individual
Prefix:
First Name:HANNA
Middle Name:
Last Name:CHRISTOPHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15252 N 100TH ST UNIT 1162
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-3895
Mailing Address - Country:US
Mailing Address - Phone:801-781-0155
Mailing Address - Fax:
Practice Address - Street 1:2406 E THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7912
Practice Address - Country:US
Practice Address - Phone:602-956-3580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-10
Last Update Date:2019-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS023982183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist