Provider Demographics
NPI:1134574585
Name:HANNEMANN, KRISTIANNE (PHARMD)
Entity type:Individual
Prefix:
First Name:KRISTIANNE
Middle Name:
Last Name:HANNEMANN
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 1:581 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94105-2847
Mailing Address - Country:US
Mailing Address - Phone:415-777-1654
Mailing Address - Fax:415-882-7995
Practice Address - Street 1:581 MARKET ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105-2847
Practice Address - Country:US
Practice Address - Phone:415-777-1654
Practice Address - Fax:415-882-7995
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-03
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA70719183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist