Provider Demographics
NPI:1982044434
Name:HASAN, MICHAELA N (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAELA
Middle Name:N
Last Name:HASAN
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 1:1303 NORTHRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-9053
Mailing Address - Country:US
Mailing Address - Phone:303-726-4417
Mailing Address - Fax:
Practice Address - Street 1:1303 NORTHRIDGE DR
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-9053
Practice Address - Country:US
Practice Address - Phone:303-726-4417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO19711183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist